Holiday Hazards

With the holidays quickly approaching I wanted to take time to discuss some holiday hazards to try to avoid.  The first post will deal mostly with cats and is taken from Dr. Tina Wismer's handout from a talk she gave for a rounds discussion in 2010.  Listed below are some common items that a cat might encounter during the holidays along with descriptions of possible problems.

1.) Silica Gel Packs

Desiccant packs are included as moisture absorbents. They are found in shoeboxes, electronics, medications and food. Silica gel comes in paper packets or plastic cylinders. Packages of silica gel are attractive to pets because of the rustling noise, and the packages are easy to bat around. Most ingestions will not cause clinical signs, although a mild gastrointestinal upset may occur. If a large amount is ingested, there is potential for diarrhea occurring. In most cases, the packet will be ruptured and the contents eaten. Ingestion of the intact packet may cause an intestinal obstruction.

2.) Christmas tree preservative

Christmas tree preservatives primarily contain dextrose and NPK fertilizers. The concentration of metals (copper, iron, zinc, magnesium) is usually small in commercial products. Most cats that drink water containing Christmas tree preservative develop no signs. Occasionally we can see mild GI signs, rarely, bacterial/fungal contamination of the water may lead to more severe signs.

3.) Christmas trees

Christmas trees may be one of several species. The most common are: Douglas fir (Pseudotsuga menziesii), Balsam fir (Abies balsamea), Black spruce (Picea mariana), Blue spruce (Picea pungens), White spruce (Picea glauca), Scotch pine (Pinus sylvestris), Norway spruce (Picea excelsa), Red Pine (Pinus resinosa), and Red spruce (Picea rubens). The most common clinical signs after ingestion of the needles are vomiting, anorexia, abdominal pain and depression.

4.) Poinsettias

The toxicity of poinsettias is generally overrated. The plants do contain diterpene esters, but large quantities must be ingested for signs to develop. Most cats just experience mild, self-limiting vomiting that resolves with little to no treatment.

5.) Mistletoe

Most ingestions involve American mistletoe (Phoradendron spp.). Mistletoe contains lectins, but ingestion of a few leaves or berries will generally cause just a mild gastritis. If purchased in a store, the berries frequently have been removed and replaced with plastic "berries" which can be a foreign body. Large ingestions may require decontamination and cardiovascular monitoring.

6.) American Holly

American holly (Ilex opaca)is a member of the Aquifoliaceae family. All parts of the holly plant are considered to contain potentially toxic compounds, including methylxanthines, saponins, and ilicin. True toxicoses not generally expected in cats. Most ingestions cause gastrointestinal irritation and depression. Recent ingestions can usually be managed with dilution and monitoring at home.

7.) Lily

Members of the Lilium and Hemerocallis genera (Easter lilies, tiger lilies, day lilies, etc.) cause acute kidney failure in cats. The water soluble toxic principle is unknown. Even minor exposures (bite on a leaf, ingestion of pollen) may result in toxicosis, so all feline exposures to lilies should be considered potentially life-threatening. It should be noted that not all plants with “lily” in the name are members of Liliaceae.

Affected cats often vomit within a few hours after exposure. Within 24 to 72 hours of ingestion, kidney failure develops, accompanied by vomiting, depression, anorexia, and dehydration. Elevations in BUN, creatinine, phosphorus and potassium are detectable as early as 12 hours post ingestion. Creatinine elevations may be especially high.

In severe cases, death or euthanasia due to acute renal failure generally occurs within 3 to 6 days of ingestion. When initiated within 18 hours of ingestion, decontamination (emesis, oral activated charcoal, and cathartic) and fluid diuresis for 48 hours have been effective in preventing lily-induced acute renal failure. Conversely, delaying treatment beyond 18 hours frequently results in death or euthanasia. Baseline renal values should be obtained upon presentation and then repeated at 24 and 48 hours. Because the tubular injury from lily ingestion spares the renal tubular basement membrane, regeneration of damaged tubules may be possible. In severe cases, peritoneal dialysis may aid in managing renal failure until tubular regeneration occurs (10-14 days or longer).

8.) Ice Melts

Many brands of sidewalk ice melts are on the market. The most common ingredients in these ice melts are sodium chloride, potassium chloride, magnesium chloride, calcium carbonate, and calcium magnesium acetate. A few ice melts contain urea. Cats may be exposed by walking on the ice melts themselves or by ingesting granules brought inside on the shoes of the owner’s.

Ingestion of urea is not a toxicity issue in non-ruminants. Ingestion of sodium, potassium, calcium and magnesium salts can lead to vomiting and electrolyte abnormalities. Monitor electrolyte levels and treat with appropriate fluid therapy.

9.) Liquid Potpourri

Liquid potpourri is commonly used during the holiday season. Cats are often exposed to liquid potpourri by direct ingestion from simmer pots or spills, or by rubbing against leaky bottles or simmer pots containing the potpourri, or from spilling the containers upon themselves. Oral exposures result following grooming. 

Exposure of cats to some types of liquid potpourris can result in severe oral, dermal and ocular damage.

Liquid potpourri is a combination of cationic detergents and essential oils. Cationic detergents can cause extensive systemic and local effects at concentrations as low as 2%. Local tissue injury caused by cationic detergents resembles that seen with exposure to other corrosives. In addition, cationic detergents can cause systemic toxicity including CNS depression, coma, seizures, hypotension, muscular weakness and fasciculations, collapse, pulmonary edema, and metabolic acidosis; the mechanism of these signs is not known. 

Treatment of local exposure includes dilution with milk or water, pain control (opioids), GI protection (sucralfate slurries) and supportive care (antibiotics, feeding tube). Systemic signs should be treated symptomatically (i.e. fluids for hypotension, diazepam for seizures, etc.).

10.) Alcohol

Due to their small size, cats are far more sensitive to alcohol than humans are. Even ingesting a small amount of a product containing alcohol can cause significant intoxication. Cats are attracted to mixed drinks that contain milk, cream or ice cream (e.g. White Russian, alcoholic eggnog, Brandy Alexander). Ethanol is rapidly absorbed orally and signs can develop within 30-60 minutes. Alcohol intoxication commonly causes vomiting, loss of coordination, disorientation and stupor. In severe cases, coma, seizures and death may occur. Cats who are inebriated should be monitored by a veterinarian until they recover.

 Hope everyone has a safe and happy holiday season!