This past fortnight or so we’ve seen a handful of cases in which dogs which have been struck down with severe whole-body tremors and seizure-like episodes shortly after (or while they are on) a walk.
Each dog was from a different part of town, and all were out walking in different areas.
Initially we didn’t really know what was happening (rather worrying in itself), but what tipped us off about the cause was the fact they didn’t respond very well (if at all) to our usual first-line treatments of choice: either diazepam or midazolam.
Luckily, they did respond to our next line drug, which was phenobarbitone – or, in one particularly severe case, a propofol constant-rate infusion.
All these dogs had been out of the owners’ sight for a short time during their walks, so may well have ingested (among other possibilities) tremorgenic mycotoxins. These – such as penitrem A and roquefortine – are well documented in literature, such as the BSAVA/VPIS Guide to Common Canine and Feline Poisons.
It could be worth checking with your lab to see if they can do testing on vomitus for these toxins. Although the patient will likely have recovered by the time you get the results, it gives you a diagnosis if they are detected.
The cases we saw recently were thought too severe to induce vomiting; the patients were recumbent, and after we got the tremors under control they weren’t sufficiently conscious to make vomiting safe.
Some authors mention gastric lavage as a means to gastric decontamination, and also using stomach tubes to instil the first doses of activated charcoal. So far we haven’t done this and all of our treated cases have recovered. However, it’s certainly something we may try in future cases – and I suspect we’ll be seeing this sort of thing more frequently with the advent of food recycling and composting by councils and some dogs’ propensity for bin-raiding!
On a slightly different note, we also continue to see fair numbers of chocolate ingestions.
One Jack Russell recently ate enough dark chocolate to kill a German shepherd! Fortunately, the owners were quick off the mark and got her to us within minutes of the discovery. In the end all the lucky terrier had was a slightly raised heart rate for a few hours after vomiting her haul up in a well-lined cage!
This is one of the few things we’ll actually admit as soon as they arrive – time is of the essence, and if the patient is left to queue in the waiting room you can lose the benefit of time.
They will be whisked through to the prep room after some questions from the nurse about their general health, and after a speedy physical exam they’ll be given their dose of apomorphine and put in a kennel with a few layers of incontinence pads down both inside the kennel and outside the (mesh) door.
Incontinence pads are useful for this because they can absorb a fair amount of fluid. If you leave the vomit in them it will dry out the vomit for inspection and rummaging later.
By weighing the pads before and after the vomit (we actually have the weight written down on the back of the “rapid access” cupboard door) we’ve been able to “guesstimate” that some or all of the chocolates have been chucked up. Not entirely reliable, I know, but it does give you a better idea of whether it has all come up, or whether some may have gone through to the small intestine.