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References in here refer to Washington State, but this applies to any place with an algae bloom.

Blue-Green Algae

What is blue-green algae?

Blue-green algae are actually bacteria that have qualities similar to algae and other plants. These bacteria are cyanobacteria – cyan means “blue-green” – and are commonly found on land and in lakes, rivers, ponds, and in estuaries and marine water.

What is a blue-green algae bloom?

A combination of warm temperatures, sunlight, and nutrient-rich waters can cause blue-green algae to reproduce rapidly, or “bloom.” Within a few days a clear lake, pond, or ditch can become cloudy with algae growth. Blue-green blooms usually float to the surface and can be several inches thick near the shoreline.

Although blue-green blooms can create nuisance conditions and undesirable water quality, most are not toxic. A blue-green algae bloom:

  • Often looks like green paint floating on the water, but can also look bluish, brownish, or reddish green.
  • Is made up of extremely small organisms that are hard to pick up or hold.
  • Is most common in the summer and fall but can occur anytime.

What is a toxic bloom?

Some blue-green algae produce toxins or poisons. In their toxic form, blue-green algae can cause illness in humans, pets, waterfowl, and other animals that come in contact with the algae. Toxic blooms can kill livestock and pets that drink the water.

Signs of a toxic bloom may include:

  • Dead fish, waterfowl, or other animals.
  • Sudden, unexplained sickness or death of a cat or dog, especially if it has algae on its mouth, legs, or feet.
  • Skin rashes on humans after being in the water.

Eventually the toxins break down in the water and are destroyed naturally.

How do the toxins affect animals and humans?

Blue-green algae can produce both nerve toxins (neurotoxins) and liver toxins (hepatotoxins). Call your doctor or veterinarian right away if you or your pets or livestock have signs of poisoning.

Residential drinking water is sometimes taken from a lake. If this is the case and a bloom occurs, do not drink the water until laboratory testing shows the water is safe.

Neurotoxin (Nerve) Poisoning
  • In people signs may include numbness of the lips, tingling in fingers and toes, and dizziness.
  • In animals signs include weakness, staggering, difficulty breathing, convulsions, and death.
  • Signs appear within 15–20 minutes after ingestion.
Hepatotoxin (Liver) Poisoning
  • Signs include abdominal pain, diarrhea, and vomiting in humans and death in animals.
  • It may be hours or days before signs of liver poisoning appear.

What if I see a bloom?

Laboratory tests of water samples can confirm whether or not a bloom is toxic. Contact your local environmental agency about having water tested.

What happens if a test is positive for toxins?

If a test shows that a bloom is toxic, county health officials will decide whether to close the lake for recreation, post notifications of potential health concerns, or wait for further testing.

Can testing ensure that all areas of a lake are safe?

No. Blue-green algae blooms are known to be very patchy in nature. Higher densities may be present in areas not surveyed, particularly along shorelines. Recreational users should avoid contact with water whenever surface concentrations of algae are evident or when the lake has an obvious green to blue-green appearance.

How is it determined when the water becomes safe once a bloom is reported?

Washington State Department of Health recommends testing the water once a week after toxin levels are above a certain concentration. Recreational use should be avoided until levels drop below recommended guidelines. Local health officials will decide when to re-open the area.

Can I eat fish from cyanobacteria contaminated water?

Toxins can accumulate in fish tissues, especially in the liver, kidneys and other organs. Exercise caution when considering eating fish caught in areas where major cyanobacteria blooms occur. Before eating, remove internal organs, which may contain more of the toxin.

How can I help?

  • Learn how to identify and report blooms.
  • Caution others to avoid water when blooms occur, and keep pets and livestock away.
  • Report algae blooms to your local health department or the Washington State Department of Ecology.
  • Limit use of fertilizers. These contain nitrogen and phosphorus that find their way to lakes and streams and contribute to blooms. Phosphorus is known to contribute to algae growth.  A new law in Washington, RCW 15.54.500, discourages homeowners from using fertilizers with phosphorus on healthy lawns.

https://www.doh.wa.gov/CommunityandEnvironment/Contaminants/BlueGreenAlgae

Brucellosis in a dog, raw meat origin

By Scott Weese on May 20, 2018

A recent report from the Netherlands in Emerging Infectious Diseases (van Dijk et al 2018) describes a new twist on raw feeding concerns, Brucella suis infection.  Here’s the short version of the story:

A dog in the Netherlands developed fever, ascites (fluid free in the abdomen) and inflammation of the testicles.  After failing to respond to antibiotics, it was taken to surgery to be neutered.  In the process, culture samples were collected from the epididymis (tissue adjacent to the testicle) and from the abdominal fluid. Brucella suis was identified in both samples, which presumably caused a bit stir in the lab and the clinic since this bacterium is a rarely identified, can also infect people and is federally notifiable in the Netherlands (i.e. the government has to be contacted when it’s found). Ultimately, the dog was euthanized after failing to respond to further treatment.

Because this is a notifiable disease, there was an investigation. The dog did not have any of the typical exposures that would increase the risk of Brucella infection, such as contact with wildlife or livestock, breeding, or travel to brucellosis-endemic areas.  The dog’s raw, rabbit-based diet that was imported from Argentina therefore became the leading suspected source. Brucella suis was ultimately identified in samples from a 30,000 kg batch of raw rabbit imported from Argentina, a country where B. suis is present.

It’s a single case report so we can’t get too worked up about it, but it’s noteworthy for a couple reasons:

  • Reason 1 is the disease – brucellosis is a nasty. It can be hard to treat, is potentially zoonotic, and sometimes results in public health-mandated euthanasia of the dog.
  • Reason 2 is the importation aspect. The dog wasn’t imported but the bacterium was, via food. We’re trying to increase awareness of the need to query travel and importation history in pets, as it can significantly impact disease risks. Querying diet origins is even tougher.  While most people know where their dog has been in the past few weeks, they may not know much about where their dog’s diet has been. With commercial processed food, it’s not a big deal, but with higher-risk food like raw meat, importing food can be similar to the dog visiting the country of origin, from a disease standpoint. With raw meat, knowing where the meat came from and the disease risks in those areas may be important, but often not easy to find out.

The incidence of disease in dogs and cats associated with raw meat feeding isn’t clear, and is probably low. Nevertheless, I recommend avoiding raw meat feeding, especially in  high risk households (e.g. with elderly individuals, kids less than 5 years of age, pregnant women or immunocompromised individuals). However, if raw meat is to be fed, some basic precautions can used to help reduce the risks.  For details, see the raw meat infosheet .

 Published: 2018.05.09 11:15 AM

 A new consumer study that reveals that there are knowledge gaps among U.S. pet owners related to the identification, prevention and treatment of fleas and ticks. Conducted by The Harris Poll on behalf of Merck Animal Health, the online study of more than 1,300 pet owners, defined as those who own a dog and/or cat, found that despite the dangers of flea infestations, ticks and Lyme disease, many pet owners may not be as knowledgeable—or as prepared—as they think. In fact, one third (33 percent) say that they do not give their pets regular flea/tick medication and nearly half (48 percent) don’t bring their pets in for routine exams to protect against these parasites.

Overall, the study found that when it comes to avoiding and treating for these pests, pet owners tend to overestimate their levels of knowledge and readiness. Specifically, more than three in five (61 percent) say they are “very knowledgeable” about fleas and ticks; however nearly two in five (38 percent) were unable to correctly identify at least one symptom commonly associated with Lyme disease. Many similarly demonstrated some level of confusion over common facts and myths—including more than one in four (27 percent) who falsely believe that fleas and ticks are only active in the spring and summer months, and one quarter (25 percent) who falsely believe that ticks can only be found in heavily wooded areas.

Younger pet owners (those aged 18-34) were especially susceptible to misinformation about fleas and ticks, and are more likely than older pet owners to falsely believe: fleas and ticks are only active in the spring and summer months (34 percent versus 24 percent of those aged 35-plus); ticks can only be found in heavily wooded areas (36 percent versus 19 percent aged 35-plus); and that dogs and cats living in urban areas don’t need flea and tick protection (15 percent versus 4 percent aged 55-plus). However, the study confirmed that nearly all pet owners, regardless of age, want to keep their pets free of fleas and ticks, with 90 percent citing that they would “do anything” to protect their pets from these pests.

These knowledge gaps are particularly concerning after a new report from the Centers for Disease Control and Prevention has found that human illnesses from mosquito, tick and flea bites more than tripled in the United States from 2004 to 2016. According to the report, there were more than 36,000 Lyme disease incidents reported in the United States in 2016 alone. Fleas and ticks can easily latch onto dogs and cats, and can spread serious illnesses, including Lyme disease. Once inside a home, they can also bite and pose health risks to human family members. Ticks can be found in most states in the U.S.; the Northeast, Mid-Atlantic and Great Lakes regions have particularly high risks of Lyme disease.

“Lyme disease has been found in every state in the U.S., and can be fatal to our four-legged family members if left untreated,” said Dr. Dan Markwalder of Companion Animal Hospital in Chicago. “Since nearly all dogs and cats are at risk of picking up fleas and ticks and transmission of the disease occurs within as little as 24 to 48 hours, preventative measures are key. No matter the season or habitat, flea and tick protection is essential for all canine and feline pets, year-round.”

According to the study, almost three-quarters of pet parents (72 percent) don’t research flea and tick prevention, and only half (50 percent) say they treat their pets year-round. 

“Fleas and ticks can carry serious, life-threatening diseases, and they are active in almost all climates and environments throughout the U.S.,” said Dr. Dottie Normile, associate director, scientific marketing affairs at Merck Animal Health. “This study shows just how important it is for pet parents to be informed and prudent when it comes to protecting their pets from these pests.”

To keep pets safe from fleas and ticks, Drs. Markwalder and Normile recommend that pet owners: consult a veterinarian to have pets protected year-round, check pets and family members regularly for ticks, remember that indoor pets are as much at risk of contracting fleas and ticks as outdoor pets, and visit a doctor or veterinarian right away if you suspect that a person or a pet has come into contact with ticks or fleas.

By Pet Product News Staff

I was going to write about ticks but the canine influenza is spreading like a wildfire, so this post is about that.
This is part of an article about the flu spreading in Ontario, Canada but it’s all over California and the west coast.
So…..
Here are some key messages (for dogs anywhere, but particularly those in areas where canine flu has been confirmed):

If your dog is sick, keep it away from other dogs.

If you are out with your dog and see a sick dog, keep your dog away from it.
If you have contact with a sick dog, wash your hands (and ideally change clothes) before you touch your dog.
Most dogs with influenza get over it on their own. As long as they are bright, alert, eating and don’t have yellowish nasal discharge, we typically do not provide any specific treatments beyond cough suppressants, if coughing is excessive.
If your dog has signs that could be consistent with influenza (e.g. cough, nasal discharge, fever, runny nose or eyes) and you are taking it to your veterinarian, make sure you call the veterinary clinic first so that they can use measures to prevent exposure of other dogs at the clinic (e.g. admitting your dog directly to an exam room or isolation area).
If your dog is sick and has been at a kennel, doggy daycare, puppy class, or any other event, contact the owner/operator to let them know.
If your dog is diagnosed with influenza or has signs consistent with influenza, it should be kept away from other dogs for 4 weeks (even if it no longer looks sick sooner than this).

Dogs that should be prioritized for vaccination are:
 
Dogs at increased risk of exposure to the virus
 
Dogs that attend kennels, classes, day cares, shows/competitions and other areas where many dogs mix.
 
Dogs that are at increased risk of severe disease if they get infected
 
Elderly dogs.
Dogs with underlying heart or respiratory disease.
Bulldogs and other brachycephalic breeds.
Breeding kennel dogs.
 
Zoonotic potential
 
H3N2 CIV is different than the common H3N2 human (seasonal) influenza virus. There is currently no evidence that H3N2 CIV can infect people.
 
However, the potential for human infection cannot be discounted. Of greater concern is the potential for re-assortment of human influenza and CIV, if a dog
(or person) is infected with both strains at the same time, as occasional infections of dogs with human H3N2 or H1N1 influenza viruses have been identified.
 
Re-assortment of influenza viruses is of concern because it can potentially result in a virus that is readily able to infect people but is different enough from other
human influenza viruses that people have no immunity from previous influenza infection or vaccination.
 
I know what you’re thinking: “Didn’t we get rid of rabies?” It depends on which domesticated species we’re talking about. In dogs, we’re doing great! In cats, not so much.
source-image
Aug 14, 2017

“I am!” “I am!” “Me too!” (Shutterstock)Rabies has been a public health issue in the United States almost since the beginning of the nation itself. It appears that the disease originated in the Old World (i.e. Europe) with the first outbreak likely in Boston in the late 1700s. Since then, great strides have been made in the control and prevention of the disease as the mystery of the virus’s epidemiology has been illuminated. These days, post-exposure prophylaxis no longer includes removing the frenulum linguae (the mucous membrane that attaches the tongue) in an effort to remove the “tongue worm” or repeatedly submerging the patient in a pond or hot oil when a pond is not available.1 Thank goodness!

From “mad dogs” to wildlife

For centuries, it was clear that encounters with “mad dogs” were responsible for most transmissions to humans, even though little else was accurately understood for some time. In fact, up until as recently as the 1960s, dog bites were the most common cause of rabies in people in the United States.2

Since then wildlife reservoirs have become the predominant source of rabies outbreaks and subsequent human exposures in the United States. In the last four decades, domestic animals have been replaced by wildlife as the most commonly reported sources of human exposure, and true elimination of the disease in free-ranging wildlife seems unlikely. Different wildlife reservoirs maintain rabies in different regions of the United States: skunk, fox, raccoon and bat.

Despite the fact that rabies continues to provide a public health threat, many veterinary practitioners fail to recognize its persistence. Practitioners are not the only ones wearing rose-colored glasses and forgetting that vaccination alone is not the “silver bullet” for continued control of this nearly 100% fatal disease. If vaccination is the foundation of rabies control, then animal control is the cornerstone of that foundation. Indeed, the eventual elimination of the massive population of stray dogs contributed at least as much as vaccination campaigns to the elimination of canine rabies in the U.S.1

Your clients are likely familiar with the rabies threat on left, but what about the one on the right? (Shutterstock)The rise of the rabid cats

Thanks to significant programs for animal control, stray dogs no longer roam the streets in large packs ripe for disease maintenance and transmission. Dogs are no longer the most commonly reported rabid domestic animal—cats now have a firm hold on the title. Cats were reported rabid four times more than dogs in recent years.2 Despite the ready availability of an efficacious vaccine (several vaccines, in fact), why are cats standing atop the rabies leader board among their domestic peers? The cause is likely multifactorial.

Cats are not routinely seen by veterinarians for preventive care. In fact, by some estimates, nearly 50% of owned cats are not seen for vaccinations. Surely this miscalculation of the import of routine care by cat owners is significant and contributes to the increase in reported rabid cats. But many cat owners keep their cats indoors exclusively, thereby severely limiting their rabies exposure. Still other owners complete the kitten vaccination series and simply fail to maintain preventive care in adult cats, likely providing some rabies immunity through initial vaccination.

An oft ignored, but increasingly more significant variable in the rise of felines in the rabies world is support for allowing large populations of stray cats to persist in urban areas. In an incredible show of “rabies amnesia,” some municipalities allow or encourage feeding of stray cats to support the populations. Many stray cat populations are maintained by charity groups or individuals at surprisingly significant financial cost. Such stray cats are trapped, neutered, vaccinated for rabies and then subsequently re-abandoned postoperatively. Setting aside the welfare implications of such treatment, these “TNR” programs do not effectively prevent or control rabies in these stray cat populations as originally posited.3

Where do we go from here?

Since stray dog population control was a cornerstone in the elimination of canine rabies in the U.S. and its subsequent persistent control, it stands to reason—and peer-review—that stray cat population control will be key in significantly decreasing rabies in cats as well. Despite the growing popularity of stray cats, it’s important to remember that rabies remains a real public health threat in the U.S. Rabies has no consistently effective clinical treatment or cure to date. Our only response centers on the prevention of the onset of clinical signs with aggressive prophylaxis in people and exposed pets. People are not reported as infected with rabies if appropriate post-exposure prophylaxis (PEP) is completed. Thus, a great number of people are exposed each year in the U.S., but the actual number of cases of human rabies reported in the U.S. is very low. These case numbers, or lack thereof, are misleading if one is not careful and can present the rosy picture of a nation without rabies.

Alas, we have not yet eliminated the risk and should take care that animal control policies do not allow the threat to continue to grow in our communities. It is vital that veterinary practitioners get engaged with their local public health departments and with other municipal authorities to provide guidance when necessary for animal control decisions. Veterinary practitioners should also educate their clients on the risk of allowing pets (including cats!) to roam freely. Even a one-night adventure outside for a cat could be life-threatening for many reasons, including an encounter with a rabid skunk or raccoon. Keep your patients and their owners safe from rabies by educating folks about the risk of rabies that still exists in the U.S.

References

1. Baer GM. The natural history of rabies. 2nd ed. Boca Raton, Florida: CRC Press, 1991;1-20.

2. CDC. Rabies in the U.S. and around the world. Available at: https://www.cdc.gov/rabies/location/index.html. Accessed on 7/22/17.

3. Roebling AD, Johnson D, Blanton JD, et al. Rabies prevention and management of cats in the context of trap, neuter, vaccinate, release programs. Zoonoses public health 2014;61(4):290-296.

The NAVTA and the powers that be are campaigning – neigh they have passed- an initiative to turn our hard-earned credentials into bed pan cleaners. WHAT?

I’m sorry, but I do NOT like the idea of being called a veterinary Nurse, even if I am not actively practicing as a tech.

Here is their logic:

 The National Credential Initiative
  • The goal of the initiative is to standardize the credential for our profession in terms of credentialing requirements, title, and scope of practice throughout the nation.

  • A standardized title should be used in all 50 states; in addition, a standard should be set in all 50 states for maintenance of credentials

  • A standardized credential will unify the profession and grow professional recognition

  • The veterinary consumer needs to understand what credentialed veterinary technicians/nurses do on a daily basis in regards to patient care

  • Pet owners are demanding qualified veterinary nursing personnel, which leads to consumer protection and patient care

    OK, ok, I DO agree with the first one. I don’t however, believe this will change the last one perception wise. I honestly feel this will confuse the issue even further. How you ask?
    I’m glad you did…

First of all, how is this going to UP the understanding of the average Joe Or Joelene into understanding what we do as Vet Techs?

Nurses are generally perceived- unless they have NP (Nurse Practitioner) after their name- as people who get you out of bed at the hospital, tend to your wounds at the doctors office or stand by while your gyno digs for gold…. wait, ok scratch that image even if it’s true.

The point is, Nurse Ratched got her name for a reason.  Here is more on their take:

Credential Woes

Currently, a VT is designated a certified VT, registered VT, licensed VT, or licensed veterinary medical technician (LVMT), depending on the credentialing state. (See Table 1.) The lack of standardization has led to widespread confusion regarding the VT’s role within the veterinary profession and among members of the general public, who do not clearly understand VT credentialing, leading to these members of the profession having little perceived value.

YES of course that makes sense but HOW does changing everyone into a NURSE with a wave of their legislative wand fix that?
Hasn’t the issue been, and will CONTINUE to be that Vet Techs are simply not respected, promoted or advertised enough for the public (PET owning public that is) to understand what we do behind those closed doors?

Does your clinic tell YOU what their Vet Techs do? Do you see them out in the office talking to clients, selling diets, explaining things to a new client or a bereaved one? Does them being  a NURSE make that change somehow?

IN my experience, and from what I read in my Vet Techs United group on Facebook, the perception isn’t going to change no matter what we are called, UNTIL VETERINARIAN’S STEP UP TO THE PLATE AND PROMOTE US TO THE PUBLIC!!!

I believe Dr. Andy Roark had a similar take on this here.
https://www.youtube.com/watch?time_continue=17&v=brKFkZBzn-c

And here’s another article on the subject: http://www.drandyroark.com/open-letter-nurses-colleagues-veterinary-nurses-respond/

Here’s what Veterinary Team Brief has to say:
https://www.veterinaryteambrief.com/article/veterinary-nursing-action#veterinarynurseorveterinarytechniciananupdateonnationalcredentials

I’m now seeing this everywhere:

“veterinary technicians/nurses” being used in sentences in articles.

Tell me what your thoughts are. Opposed, and if so, why?

Agree, and if so, why?

Is there anything that can be done instead of/in spite of/because it should have been done decades ago to help the REAL problem?

Lack of support and recognition by the very GROUP we work with/for- Veterinarians.

http://veterinarynews.dvm360.com/first-documented-identical-twin-dogs-delivered.

Irish Wolfhound puppies Cullen and Romulus were confirmed genetically identical after discovering they shared the same placenta during a Cesarean delivery.

 

Kurt de Cramer, BVSc, MMedVet (Gyn.), of Rant en Dal Animal Hospital in Mogale City, South Africa, noticed distress and prolonged abdominal straining during a Cesarean section on a female Irish wolfhound when she was due to give birth. He also noticed an unusual bulging by her uterus, according to a report from the BBC.

Though there were five live puppies, each with their own placenta arranged single-file within the uterus, de Cramer noticed that there were two others attached to one placenta. “When I realized that the puppies were of the same gender and that they had very similar markings, I also immediately suspected that they might be identical twins having originated from the splitting of an embryo,” says de Cramer in the BBC report.

According to the report, after calling upon other reproductive specialists, de Cramer and the team he had assembled obtained blood samples from the twins once they reached 2 weeks of age in order to genetically confirm what de Cramer suspected. The results showed that the puppies were genetically identical.

“There have been rumors about twin dogs before,” says Carolynne Joone, lecturer on veterinary reproduction at James Cook University in Townsville, Australia. “We just happened to be lucky enough to confirm it genetically.”

Even though this is the first confirmed instance of genetically identical canine twins, it is impossible to tell just how rare the occurrence is. “It has taken so long for us to find a monozygotic pair, so they are probably rare,” Joone says. “But so many of them will have been born naturally and blissfully unaware.”

But for identical twin pups to be delivered naturally is dangerous. “It is even less likely for placenta-sharing puppies to survive,” de Cramer says in the BBC report, “because of several complications relating to nutrient and oxygen supply from a single placenta having to do the job that is normally done by two placentas.”

Though they were slightly smaller at birth, the twin puppies, Cullen and Romulus, are still doing well.

You can read more on the study and research of this case here.

Have you heard about the newest line of defense against fleas and ticks? Check out new Simparica:

http://www.simparica.com/

There is also Bravecto:

http://us.bravecto.com/

Revolution for cats:

http://revolution4cats.com/

Vectra:

http://www.vectrapet.com/#!pests

and Nexguard:

http://www.nexgardfordogs.com/

 

Get informed. Ask your vet about the best flea and tick prevention for your pet!

Originally published November 26, 2015 at 3:08 pm

Blue Buffalo is recalling some of its Cub Size Wilderness Wild Chews Bones that were sold in PetSmart stores in Washington and eight other states because they may be contaminated with salmonella.

By Seattle Times staff

The Seattle Times

Blue Buffalo, which makes natural foods and treats for dogs and cats, is recalling some of its Cub Size Wilderness Wild Chews Bones that were sold in PetSmart stores in Washington and eight other states, because they may be contaminated with salmonella, according to the Food and Drug Administration (FDA).

The chew bones come individually shrink-wrapped in plastic with UPC number 840243110087 printed on a sticker affixed to the product, and an expiration date of November 4, 2017, printed as “exp 110417” on the shrink-wrap, the FDA says. It is the only lot affected.

They were sold starting Nov. 19 in PetSmart stores in Washington as well as California, Kansas, Michigan, Minnesota, Montana, Nevada, Oregon and Utah. Consumers who have purchased the bones are urged to dispose of them or return them to the place of purchase for a full refund.

Salmonella can affect animals eating the product, and there is risk to humans from handling contaminated items.

Surprise! Xylitol appears in products you’d never suspect. At Pet Poison Helpline (PPH), we’ve discovered that xylitol, a sweetener that causes hypoglycemia and hepatic necrosis in dogs, is showing up in some very unexpected places.

New products on the market such as nasal sprays, OTC sleep aids, multi­vitamins, prescription sedatives, antacids, stool softeners, smoking-cessation gums and other products may contain unexpectedly large amounts of xylitol. Dogs that ingest these products face a double risk—not only may poisoning result from the active ingredient but also from the xylitol. This can result in a variety of serious and unanticipated clinical signs that complicate treatment and prognosis.

Some background


(GETTY IMAGES/MATTHEW LEETE)

Xylitol is a natural sugar alcohol normally found in small amounts in many fruits and vegetables. Because of its sweet taste and plaque-fighting properties, it is frequently used as a sugar substitute in chewing gum, breath mints and dental products like toothpaste and mouthwash. Nontoxic amounts are even found in some pet dental products. Due to its low glycemic index, it is also being sold in bulk to substitute for table sugar in baking and in-home use. As a result, PPH has seen several cases of dogs becoming severely intoxicated after ingesting homemade bread, muffins and cupcakes made with xylitol.

Determining the amount of xylitol in a product

Xylitol is typically considered part of a product’s “proprietary ingredients,” so the quantity will not be listed on the package label. While some companies are willing to release the amount of xylitol in their products, many are hesitant to do so and may even ask for veterinarians to sign a confidentiality statement prior to release. At PPH we’ve worked extremely hard to obtain as much information as possible about products with known xylitol content. Most companies have been willing to share information with us for use in emergency case management but request that it otherwise remain confidential. When you’re in doubt of the xylitol quantity in a product, it’s best to contact an animal poison control center for assistance.

Interpreting the placement of xylitol in an ingredient list

In some cases, it can be helpful to use the location of xylitol within an ingredient list to estimate its quantity in the product. For example, in the United States, all foods must list their ingredients in descending order of predominance by weight. This means that the ingredient that weighs the most is listed first, and the ingredient that weighs the least is listed last. In general, for most chewing gums, the amount of xylitol is often clinically insignificant if it’s listed as the fourth or fifth ingredient. If it’s listed as one of the first three ingredients, extreme caution should be taken.

For drugs and dietary supplements, the regulations regarding the order of ingredients is considerably different. In this case, xylitol is often considered an “inactive ingredient” or “other ingredient”—and such ingredients are not required to be listed in order of predominance. Often they are listed in alphabetical order, which may lead an uninformed pet owner or veterinary professional to incorrectly assume that there is a very low concentration of xylitol in the product.

New atypical sources of xylitol

Here are some products containing xylitol that you might not expect.

Over-the-counter medications:
> Axia3 ProDigestive Antacid (flavored chewable tablets, propriety amount)
> Children’s Allegra Oral Suspension
> Fleet Pedia-Lax Liquid Stool Softener
> Umcka Cold and Flu chewable tablets (homeopathic product).

Dietary supplements, vitamins:
> KAL Colostrum Chewable, Vanilla Cream (chewable tablets)
> KAL Dinosaurs Children’s Vitamins and Minerals (chewable tablets)
> Kidz Digest Chewable Berry from Transformation Enzyme
> L’il Critters Fiber Gummy Bears
> Mega D3 Dots with 5,000 IU of Vitamin D3 per “dot” (dissolvable tablet)
> Stress Relax’s Suntheanine L-Theanine chewable tablets
> Vitamin Code Kids by Garden of Life (chewable multivitamins)
> Super Sleep Soft Melts by Webber Natural (dissolvable tablets).

To read about more atypical sources of xylitol, toxic doses, and treatment recommendations, see below.

Nasal products:
> Xlear Sinus Care Spray
> Xylear Nasal Spray (for adults and children)
> Xyliseptic Nasal Spray.

Prescription drugs:
> Abilify Discmelt Orally Disinteg­rating Tablets (aripiprazole), an atypical antipsychotic
> Clonazepam Orally Disintegrating Tablets, benzodiazepine
> Emtriva oral solution (emtricitabine), HIV-1 reverse transcriptase inhibitor
> Mobic Oral Suspension (meloxicam), nonsteroidal anti-inflammatory
> Neurontin (gabapentin) Oral Solution
> Riomet (metformin) Oral Solution, antidiabetic agent
> Varibar barium sulfate products, liquids and puddings for swallowing studies
> Zegerid Powder for Oral Suspension (omeprazole), proton pump inhibitor.

Foods with xylitol as the primary sweetener (excluding gums and mints):
> Clemmy’s Rich and Creamy ice cream products
> Dr. John’s products (hard and soft candies, chocolates, drink mixes and so on)
> Jell-O sugar-free pudding snacks
> Nature’s Hollow jams, syrup, ketchup, honey and so on
> SparX Candy
> Zipfizz energy drink-mix powders.

Toxic doses and treatment recommendations

The toxicity of xylitol is dose-dependent. The dose necessary to cause hypoglycemia in dogs is approximately 0.1 grams/kg, while the amount needed to cause hepatic necrosis is approximately 0.5 grams/kg. Most chewing gums and breath mints typically contain 0.22 to 1.0 gram of xylitol per piece of gum or per mint. Therefore only one piece of gum may result in hypoglycemia in a 10-pound (4.5-kg) dog.

Hypoglycemia is typically evident within one to two hours of xylitol ingestion but in rare cases has been delayed as much as 12 hours. Prompt decontamination via the induction of emesis in asymptomatic patients with euglycemia is essential to prevent poisoning. Activated charcoal does not bind well to xylitol and is not typically necessary or recommended. Should hypoglycemia develop, supplementation with intravenous dextrose is needed until the dog can self-regulate its blood glucose concentrations (typically 12 to 48 hours).

For dogs exposed to hepatotoxic doses of xylitol, preemptive administration of dextrose (prior to the onset of hypoglycemia) may be helpful. Additionally, close monitoring of hepatic enzymes is warranted as evidence of necrosis may be seen one to two days following exposure. Should hepatic necrosis develop, IV fluids, dextrose, hepatoprotectants and monitoring of coagulation profiles are needed.

The prognosis following xylitol exposure is excellent when the ingestion is caught early, decontamination is performed, and blood glucose is monitored frequently. The prognosis becomes guarded if the dog has already begun to develop hepatic failure.

Dr. Ahna Brutlag is associate director of veterinary services for Pet Poison Helpline and SafetyCall International, PLLC.

http://veterinarynews.dvm360.com/veterinarians-and-clients-should-know-surprising-places-xylitol-found

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