A chocolate toxicosis refresher

Chocolate often comes into your clients' homes by the bucket-full this time of year, so it's a good time to educate clients about the dangers of chocolate ingestion and to brush up on treatment.

Although chocolate toxicosis is more common in dogs, it's a potential problem with any species, says Jill Richardson, DVM, former poison information specialist with the ASPCA Animal Poison Control Center in Urbana, 111. Remind clients to keep candy out of pets' reach, not let pets in the kitchen unsupervised while baking, and never feed a dog milk chocolate as a treat because the dog may develop a taste for it and subsequently seek it out.

Chocolate contains theo-bromine and caffeine, which are both methylxanthines. The amount of methylxanthines present depends on the type of chocolate (see table). In general, the less sweet it is, the more toxic it could be. Unsweetened baking chocolate contains almost seven times more

Source: Kirk and Bistner's Handbook of Veterinary Procedures and Emergency Treatment, sixth edition. W B Saunders, 2000.

theo-bromine than milk chocolate, which is why a dog can eat an occasional piece of milk chocolate and not show clinical signs. The theobromine in chocolate-coated candy is more dilute than that in solid chocolate bars.

Clinical signs of chocolate toxicosis include vomiting, diarrhea, hyperactivity, polyuria, polydipsia, lethargy, tachycardia, cardiac arrhythmias, seizures, and death. Some of these signs can be seen with the ingestion of as little as 0.25 oz of baking chocolate by a 10-lb dog. Based on Animal Poison Control Center experience, mild signs occur in animals ingesting 20 mg/kg and severe signs are seen at doses over 40 mg/kg. The half-life of chocolate in the dog is 17.5 hours.

If clients suspect their pets have eaten chocolate, tell them to contact you immediately or call the APCC's 24-hour emergency hotline, (888) 4-ANI-HELP. Find out a) what kind of chocolate was ingested, b) the amount ingested (refer to the packaging or recipe and assume a worst-case scenario), and c) how much the animal weighs.

Treatment tips for chocolate toxicities

• Stabilize the animal if symptomatic; treat life-
threatening cardiovascular and respiratory abnormalities and control seizures.
• Use standard gastrointestinal decontamination procedures: emesis, repeated dosing with activated charcoal, and a cathartic.
• Administer fluids to help eliminate methylxanthines. A urinary catheter is recommended to prevent reabsorption of caffeine by the bladder wall.
• Provide supportive care until complete recovery.