Farbman-march vt-tox brief

146 Veterinary Technician March 2001
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.
enterohepatic recirculation 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: dfarbman@napcc.aspca.org (for nonemergency information only); web site: www.napcc.aspca.org.
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Veterinary Technician 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 cology. 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.

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