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Common Household Hazards

Sharon Gwaltney-Brant DVM, PhD
Jill A. Richardson, DVM
ASPCA Animal Poison Control Center
http://www.apcc.aspca.org

1. Ant Baits

Ant and roach baits are common objects found in households. They are also referred to as hotels, traps, or stations. The insecticides used most commonly in these baits are chlorpyrifos, sulfluramid, fipronil, avermectin, boric acid, and hydramethylnon. . The baits usually contain inert ingredients such as peanut butter, breadcrumbs, sugar and vegetable or animal, which could be attracting to pets. Exposures to these types of ant baits usually do not require decontamination or treatment. Most often, if signs are seen at all, they are mild in nature and self-limiting and are usually attributed to the inert ingredients instead of the active ingredient.

2. Silica Gel Packets

Silica gel is used as a dessicant and often come in paper packets or plastic cylinders. They are used to absorb moisture with leather, medication, and in some food packaging. Silica is considered "chemically and biologically inert" upon ingestion. However, with ingestion, it is possible to see signs of GI upset, such as nausea, vomiting, and inappetence. Additional problems could occur is the silica gel was used as a dessicant in medication, since silica could possibly absorb qualities of the medication.

3. Toilet Water (Tank drop-ins)

Tank "drop in" products typically contain corrosive agents (alkali or cationic detergents.) However, when a tank "drop in" cleaning product is used in a toilet, the actual concentration of the cleaner is very low in the bowl. With dilution by the bowl water, the cleaning agent is just a gastric irritant. Common signs seen with ingestion include mild vomiting and nausea.

4. Birth Control Pills

Each packet of oral contraceptives contains 21 tablets of estrogen and/or progesterone and possibly 7 placebo pills. Estrogen could cause bone marrow suppression at levels greater than 1 mg/kg. Some oral contraceptives also contain iron. Decontamination is not necessary unless the level of estrogen is greater than 1mg/kg or the level of iron is greater than 20mg/kg.

5. Liquid Potpourri

Liquid potpourri may contain essential oils and cationic detergents; because product labels may not list ingredients, it is wise to assume that a given liquid potpourri contains both ingredients. Essential oils can cause mucous membrane and gastrointestinal irritation, central nervous system depression, and dermal hypersensitivity and irritation. Severe clinical signs can be seen with potpourri products that contain cationic detergents. Dermal exposure to cationic detergents can result in erythema, edema, intense pain, and ulceration. Ingestion of cationic detergents may lead to tissue necrosis and inflammation of the mouth, esophagus, and stomach. Treatment is symptomatic and supportive (see Cationic Detergent section).

6. Chocolate

There are a wide variety of chocolate and cocoa products to which pets may be exposed, including candies, cakes, cookies, brownies, and cocoa bean mulches. Not surprisingly, the incidence of accidental chocolate exposures in pets occurs around holidays, especially Easter, Halloween and Christmas. The active (toxic) agents in chocolate are methylxanthines, specifically theobromine and caffeine. Methylxanthines stimulate the CNS, act on the kidney to stimulate diuresis, and increase the contractility of cardiac and skeletal muscle. The relative amounts of theobromine and caffeine will vary with the form of the chocolate (see table).

Milligrams per ounce

Compound

Theobromine

Caffeine

White Chocolate

0.25

0.85

Milk Chocolate

58

6

Semi-sweet Chocolate chips

138

22

Baker's Chocolate (unsweetened)

393

47

Dry cocoa powder

737

70

Cocoa beans may contain up to 255 mg theobromine per ounce of beans, although the exact amount will vary due to natural variation of the cocoa beans. The LD50's of theobromine and caffeine are 100-300 mg/kg, but severe and life threatening clinical signs may be seen at levels far below these doses. Based on NAPCC experience, mild signs have been seen with theobromine levels of 20 mg/kg, severe signs have been seen at 40-50 mg/kg, and seizures have occurred at 60 mg/kg. Accordingly, less than 2 ounces of milk chocolate per kg is potentially lethal to dogs.

Clinical signs occur within 6-12 hours of ingestion. Initial signs include polydypsia, bloating, vomiting, diarrhea, and restlessness. Signs progress to hyperactivity, polyuria, ataxia, tremors, seizures, tachycardia, PVC's, tachypnea, cyanosis, hypertension, hyperthermia, and coma. Death is generally due to cardiac arrhythmias or respiratory failure. Hypokalemia may occur later in the course of the toxicosis. Because of the high fat content of many chocolate products, pancreatitis is a potential sequela.

Management of chocolate ingestion includes decontamination via emesis followed by gastric lavage. Because methylxanthines undergo enterohepatic recirculation, repeated doses of activated charcoal are usually of benefit in symptomatic animals (vomiting may need to be controlled with metaclopramide). Intravenous fluids at twice maintenance levels will help maintain diuresis and enhance urinary excretion. Because caffeine can be reabsorbed from the bladder, placement of a urinary catheter is recommended. Cardiac status should be monitored via EKG and arrhythmias treated as needed; propranolol reportedly delays renal excretion of methylxanthines, so metoprolol is the beta-blocker of choice. Seizures may be controlled with diazepam or a barbiturate. In severe cases, clinical signs may persist up to 72 hours.

7. Cigarettes

Tobacco products contain varying amounts of nicotine with cigarettes containing 13-30 mg and cigars containing 15-40 mg. Butts contain about 25% of the total nicotine content. The oral LD50 in dogs is 9.2 mg/kg.

Signs often develop quickly (usually within 15-45 minutes) and include excitation, tachypnea, salivation, emesis, and diarrhea. Muscle weakness, twitching, depression, tachycardia, shallow respiration, collapse, coma, and cardiac arrest can follow the period of excitation. Death occurs secondary to respiratory paralysis.

Table of nicotine content of common sources of nicotine.
Nicotine Product Nicotine Content
Cigarettes 3-30 mg per 1 whole cigarette
cigarette butts 5-7 mg
cigars 15-40 mg
moist snuff 4.6-32 mg/ gram
dry snuff 12.4-15.6/ gram
chewing tobacco 2.5-8 mg/ gram
nicotine gum 2-4mg per piece
transdermal patches 15-114 mg per patch
nicotine nasal sprays 10 mg per mL
nicotine inhaler rods 10mg per cartridge

8. Pennies

Ingestion of coins by pets, especially dogs, is not uncommon. Of the existing US coins currently in circulation, only pennies pose a significant toxicity hazard. Pennies minted since 1983 contain 99.2% zinc and 0.8% copper, making ingested pennies a rich source of zinc. Other potential sources of zinc include hardware such as screws, bolts, nuts, etc., all of which may contain varying amounts of zinc. In the stomach, gastric acids leach the zinc from its source, and the ionized zinc is readily absorbed into the circulation, where it causes intravascular hemolysis.

The most common clinical signs of penny ingestion are vomiting, depression, anorexia, hemoglobinuria, diarrhea, weakness, collapse and icterus. Secondarily, acute renal failure may develop. Clinical laboratory abnormalities will be suggestive of hemolysis (elevated bilirubin, hemoglobinemia, hemoglobinuria, regenerative anemia) and may also indicate the development of kidney failure. Serum zinc levels may be obtained—blood should be collected in all plastic syringes (no rubber grommets) and shipped in Royal blue top vaccutainers to minimize contamination with exogenous zinc. Radiography of the abdomen may reveal the presence of coins or other “hardware” within the stomach.

Treatment for recently ingested pennies would include induction of vomiting. Activated charcoal is not indicated, as it is of little benefit in binding metals. Removal of zinc-containing foreign bodies via endoscopy or gastrotomy/enterotomy may be required. Treatment for symptomatic animals should include blood replacement therapy as needed, intravenous fluids, and other supportive care. The use of chelators may not be necessary in cases where prompt removal of the zinc source is accomplished. If chelation therapy is instituted, careful monitoring of renal parameters is important for the duration of therapy.

9. Bread Dough

Raw bread dough made with yeast poses mechanical and biochemical threats to animals ingesting it. The warm, moist gastric environment stimulates yeast growth, resulting in expansion of the dough mass, resulting in gastric distention, which if severe, can result in respiratory and vascular compromise. Perhaps more significant is the release of alcohol from yeast fermentation, resulting in profound metabolic acidosis, CNS depression and death.

Early clinical signs may include unproductive attempts at emesis, abdominal distention, and depression. As alcohol intoxication develops, the animal becomes ataxic and disoriented. Eventually, profound CNS depression, weakness, recumbency, coma, hypothermia may occur.

Management of exposure includes decontamination and treatment for alcohol toxicosis. Because emesis is often unsuccessful, gastric lavage is initially recommended. The veterinarian should be prepared to perform gastrotomy should the lavage fail to remove the bulk of the dough mass due to the glutinous nature of the dough. Treatment for alcohol intoxication should proceed as previously described.

10. Mothballs

Mothballs may be composed of either 100% naphthalene or 99% paradichlorobenzene. Naphthalene-based mothballs are approximately twice as toxic as paradichlorobenzene, and cats are especially sensitive to naphthalene. Naphthalene causes Heinz bodies, hemolysis, and, occasionally, methemoglobinemia in dogs with doses of 411 mg/kg or more (one 2.7 g mothball contains 2700 mg of naphthalene). Paradichlorobenzene primarily affects the liver and CNS, although methemoglobinemia and hemolysis have been reported in humans.

Signs of ingestion of naphthalene mothballs include emesis (early), weakness, icterus, lethargy, icterus, brown-colored mucous membranes, and collapse. Rarely, hepatitis has been reported 3-5 days post-ingestion. Paradichlorobenzene mothballs may cause GI upset, ataxia, disorientation, and depression. Elevations in liver serum biochemical values may occur within 72 hours of ingestion.

Treatment of mothball ingestion includes early emesis, activated charcoal, and cathartic. Treatment for hemolysis or methemoglobinemia (blood replacement therapy, methylene blue, etc) may be necessary. Intravenous fluid diuresis should be maintained in cases with hemolysis in order to minimize the risk of hemoglobin-induced renal nephrosis. Evidence of hepatic damage, based on biochemical values, would indicate that symptomatic therapy for general liver failure (oral antibiotics, lactulose, dietary management, etc) should be instituted.

11. Moldy Food (Tremorgenic mycotoxins)

Tremorgenic mycotoxins produced by molds on foods are a relatively common, and possibly under-diagnosed, cause of tremors and seizures in pet animals. Because of their relatively indiscriminate appetites, dogs tend to be most commonly exposed to tremorgens. These toxins are produced from a variety of fungi, however tremorgens produced by Penicillium spp. are the most commonly encountered. These molds grow on practically any food, including dairy products, grains, nuts, and legumes; compost piles may also provide a source of tremorgens. Tremorgens have a several different mechanisms of actions: some alter nerve action potentials, some alter neurotransmitter action, and while others alter neurotransmitter levels. The overall affect is the development of muscle tremors and seizures.

Clinical signs include fine muscle tremors that may rapidly progress to more severe tremors and seizures. Death generally occurs in the first 2 to 4 hours and is usually secondary to respiratory compromise, metabolic acidosis or hyperthermia. Other signs that may be seen include vomiting (common) hyperactivity, depression, coma, behavior alterations, tachycardia, and pulmonary edema.

Asymptomatic animals exposed to moldy foods should be decontaminated via emesis or lavage followed by activated charcoal and cathartic. In symptomatic animals, control of severe tremors or seizures has priority over decontamination. Seizures may respond to diazepam, however others have had better success with methocarbamol (RobaxinÒ; 55-220 mg/kg IV to effect), especially in seizuring animals. Barbiturates may be used in animals that are unresponsive to other anticonvulsants. Supportive care should include intravenous fluids, thermoregulation, and correction of electrolyte and acid-base abnormalities. In severe cases, signs may persist for several days, and residual fine muscle tremors may take a week or more to fully resolve. Testing of stomach content, suspect foods, or vomitus for tremorgens is available through the Animal Health Diagnostic Laboratory, Michigan State University (517-355-0281).

Suggested Readings

Drolet R, Arendt TD, Stowe CM. Cacao bean shell poisoning in a dog. J. Am. Vet. Med. Assoc. Vol 185(8): 902, 1984.

Gwaltney,-Brant, S. Chocolate Intoxication. Vet Med 96[2]:108-111 Feb'01 Toxicology Brief

Kore, AM, Nesselrodt A. Household cleaning products and disinfectants. Vet. Clin. North Am. Small Anim. Pract. Vol 20(2): 525-537, 1990.

Richardson, JA. Potpourri Hazards in Cats. Vet Med 94[12]:1010-1012 Dec'99 Toxicology Brief

Robinette CL. Zinc. Vet. Clin. North Am. Small Anim. Pract. Vol 20(2): 529-544, 1990.

Schell, MM. Tremorgenic mycotoxin intoxication. Vet. Med. Vol 95(4):

Tanaka J, Yamashita M, Yamashita M, Kajigaya H. Effects of tap water on esophageal burns in dogs from button lithium batteries. Vet. Hum. Toxicol. Vol 41(5): 279-282, 1999.

Tanaka J, Yamashita M, Yamashita M, Kajigaya H. Esophageal electrochemical burns due to button type lithium batteries in dogs. Vet. Hum. Toxicol. Vol 40(4): 193-196, 1998.

Valentine WM. Short-chain alcohols. Vet. Clin. North Am. Small Anim. Pract. Vol 20(2): 515-524, 1990.


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