After practicing over 26 years, one would have thought that I've seen almost everything. A few days ago, however, I saw a case that taught me something new and reconfirmed the importance of a thorough physical examination.
Toby, a very lovable 2-year-old standard poodle, came to see me with an acute history of vomiting and moderate lethargy. Toby had vomited four to five times in the last 12 hours. His owner reported seeing rat bait signs posted in her neighborhood but was confident that Toby did not eat any of it. She did confide in me that she had to remove a half eaten rabbit from Toby's mouth the other day. Lastly, she embarrassingly revealed that Toby eats goose droppings.
From Toby's history, I was fairly confident that I was dealing with dietary indiscretion (complications as a result of eating a dead rabbit and goose droppings) that upset Toby's stomach. I did a complete physical examination and collected a stool sample. We took an abdominal radiograph and saw no obvious foreign body in Toby's gastro-intestinal tract. My technician performed a fecal analysis on his stool sample looking for parasites. To our amazement, my technician discovered under the microscope bright, turquoise-blue rat bait crystals. Toby did eat rat bait! It was quite a surprise to see the remains of undigested rat bat in Toby's feces. One would have suspected that there would be no visible signs of rat bait in feces after passing through the stomach and small intestine.
This finding changed our entire diagnostic and treatment protocol. We did a complete blood cell count, chemistry profile, and a coagulation study. Typical Rat bait (like d-CON, Talon, and Contrac) interferes with the body's ability to form blood clots by blocking the production of Vitamin K1. Without this vitamin, spontaneous massive internal bleeding occurs. It usually takes two to three days from ingestion of rat bait until symptoms appear. The symptoms of rat bait ingestion include pale gums, bleeding from nose, mouth or rectum, coughing up blood, and bruising of skin. Ingestion of rat bait alone does not cause vomiting.
Fortunately for Toby, his blood work was unremarkable except for evidence of pancreatitis (inflammation of the pancreas). Toby's pancreatitis was most likely due to the ingestion of the rabbit carcass. In pets, pancreatitis causes vomiting, diarrhea and lethargy. I strongly doubt that Toby's mother would have brought him to our clinic that day if he had not been vomiting. Although an unpleasant event, the partial ingestion of the rabbit saved Toby's life. It would have been two to three days later before the clinical signs of the rodenticide poisoning would have been apparent to the owner and maybe too late to treat.
Since Toby was vomiting, we started him on injectable Vitamin K1 (the antidote for rodenticide poisoning). We will continue oral Vitamin K1 for another 30 days. For his pancreatitis, we started him on anti-nausea medication, intravenous fluids, pain medication, and drugs to calm down the inflammation in his gastrointestinal tract.
After 36 hours of treatment, Toby is beginning to feel better. The tragedy of this story is that there is still a substantial amount of rat bait on our city streets, alleys and in households. Last month, another client brought her beagle to our clinic after discovering that he had eaten a pound of rat bait that was hidden in a basement closet. Regrettably, this medical situation will most likely be repeated in another pet and may not have the lucky outcome that Toby had.
I strongly urge you to vigilantly observe your dog on walks. Do not let your pet run free in the city. There are too many delectable and dangerous things in our environment. It only takes a second for your dog to eat something that he/she should not consume. In addition, I urge you to write to your alderman and the City of Chicago to encourage them to use alternative rat control methods and banning the over-the-counter sale of rodenticides. Laying rat bait carelessly in the alley, on our streets, and in our homes is extremely dangerous. Although Chicago Rodent Control officers say they only place the rat bait in burrows (deep rat holes), I find it inconceivable that all the bait remains in the burrows -- especially when we know that our wild life (owls, birds and deer) are dying from rat bait ingestion.
I strongly recommend better and safer rodent control in Chicagoland area which should include more stringent garbage containment rules, only professional availability of rodenticide products, use of humane traps, and rat bait stations inaccessible to non-target animals and children!