Farbman-march vt-tox brief
146 Veterinary Technician
Dana B. Farbman, CVT
M ost veterinary professionals and pet owners are familiar with the notion that chocolate is poisonous to dogs and cats. What is it
about chocolate that makes it hazardous to pets? Are some varieties of chocolate more dangerous than others? How much must beconsumed to cause poisoning? This column addresses all these questions and provides some practical advice on how to manage
patients that have consumed this delicious but potentially dangerous food.
in which a
Toxicology Brief is contributed by veterinary technicians at the American Society for the Prevention of Cruelty to Animals–National Animal Poison Control
Center, 1717 S. Philo Rd., Suite 36, Urbana, IL 61802; hotline: 888-4ANI-HELP (888-426-4435) or 900-680-0000 (a $45 consultation fee is charged
to the caller’s telephone bill); email: firstname.lastname@example.org (for nonemergency information only); web site: www.napcc.aspca.org.
March 2001 147
The key point to remember with chocolate toxicosis (or
any other poisoning situation) is to treat the patient
, not the
Methylxanthine Concentrations in
toxicant. Providing thorough, symptomatic, and supportive
Different Forms of Chocolate1,2
care is crucial in helping patients through any medical crises.
Ms. Farbman is a graduate of the veterinary technolo-
gy program at Parkland College, Champaign, Illinois.
She has been on staff at the National Animal Poison
Control Center since January 1998. When not at
work, she spends time with her husband Shawn, her
Methylxanthine levels in these sources can vary depending on envi-
ronmental/growth conditions and the type of bean.
cat Akasha, and her three border collies, Sedona,Mesa, and Phoenix.
may even appear to bounce when dropped on their feetfrom a few inches.1,2
1. Farbman D: 10 Common toxicant exposures in animals, part I.
Champaign, IL, Parkland Coll Fall Conf Proc
, October 7,
History of recent exposure; presence of clinical signs;
and/or analysis of stomach contents, urine, or plasma for
2. Beasley VR: A System Affected Approach to Veterinary Toxi-
the presence of caffeine or theobromine can help establish
Urbana, IL, University of Illinois, 1990, pp 42–46.
3. Hooser SB, Beasley VR: Methylxanthine poisoning (chocolate
and caffeine toxicosis), in Kirk RW (ed): Current VeterinaryTherapy IX
. Philadelphia, WB Saunders Co, 1986, pp
Emesis should be induced in asymptomatic animals that
4. Management of Common Small Animal Toxicoses—Chocolate,
have ingested harmful amounts of chocolate within the past 4
Tea and Coffee. Proc ISVMA
, Springfield, IL, February 12–14,
hours. Activated charcoal with a cathartic should then be ad-
ministered because of the enterohepatic recirculation of caf-feine and theobromine1,4; repeated doses (every 4 to 6 hours,then every 8 to 12 hours) of activated charcoal may decreasethe half-life of theobromine. Plain activated charcoal isdosed at 1 to 2 g/kg body weight. If using 10% suspension(100 mg/ml), the dose is 10 to 20 ml/kg, or one 240-ml con-tainer per 12 to 24 kg (25 to 50 lb) body weight.1,4
Animals with clinical signs should be stabilized before
decontamination measures are taken. Cardiac functionshould be monitored with echocardiography. Bradycardiacan be treated with intravenous (IV) atropine (0.01 to 0.02mg/kg). If needed, IV β-blockers (e.g., metoprolol, propran-olol) may be administered (0.04 to 0.06 mg/kg) but shouldnot exceed 1 mg/2 minutes and the patient should be closelymonitored for hypotension. IV lidocaine (1 to 2 mg/kg fol-lowed by a 0.1% solution administered at 30 to 50µg/minute) can also be used (in dogs only) if β-blockers failto control tachycardia.1,4 Corticosteroids are generally con-traindicated because they can interfere with methylxanthineexcretion. IV diazepam (0.5 to 2 mg/kg), IV phenobarbital(2 to 6 mg/kg slowly), or other barbiturate or even gas anes-thetics can be used to control seizures.
Catheterizing the urinary bladder and administering fluids
may aid methylxanthine excretion and prevent reabsorptionthrough the urinary bladder.1,2,4 Controlling vomiting andmaintaining hydration and electrolyte balance are also impor-tant, particularly in severely affected animals. Pancreatic en-zymes should be monitored because of the risk for pancreati-tis due to the high fat content in various types of chocolate.
IDENTITET INNLEDNING: Om meg som skriver og det jeg har skrevet Jeg heter Julie Elise Tuvik og er 84-modell. For tiden er jeg student i Oslo og tar fagene religion, fransk og engelsk. Hvis alt går etter planen, ender jeg opp som lærer på en videregående skole. Jeg har drevet en del med arbeid som leir, kor, ungdomsklubber og ledertrening. Jeg har vært et år i Paris og jobbet i en kirke
Fisiopatología y abordaje de la disfunción sexual C. Valles-Antuña a, J.M. Fernández-Gómez b,c, S. Escaf b,c, M.C. Fernández-Miranda a, F. Villanueva-Gómez a, F. Fernández-González a FISIOPATOLOGÍA Y ABORDAJE DE LA DISFUNCIÓN SEXUAL EN PACIENTES EPILÉPTICOS Resumen. Objetivo . Revisar la disfunción sexual en epilépticos, un aspecto de la enfermedad a menudo infravalorad