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as we did last week, we have a very special
guest with us this week. It's a very good friend
of mine, a veinary colleague and way more trained than
I am. She is a double boarded expert. Just to
talk about what that means. We all go to bed school,
we get our dvms, and then we have to go
through a process if you want to get specialized. So
let me introduce doctor Justine Lee and Justin why don't
you tell us what you had to go through to
become not only boarded once, but boarded twice?
Speaker 3: Well, first off, thanks for having me on the show.
Part of being a board sort of fed specialist just
means that we're really geeky and went to school or
went to additional training through an internship or residency. So
it's usually a one year internship and a three year residency.
So I did an additional five years of training after
Vetnory School just to specialize in the field of emergency
critical care and then also toxicology.
Speaker 2: Now, did you have to do a separate residency for toxicology.
It just kind of came along with it.
Speaker 3: No, that one was a unique one. Based on working
at an animal poison control and being the associate director
there for five years, so I'm basically credentialed. In took
really hard exams and thankfully was able to pass well.
Speaker 2: Obviously everybody out there, Justine is really smart and that's
a good thing, and just you'll tell from the personality
an amazing personality as well.
Speaker 4: Justin and I are working together on.
Speaker 2: A project that we were still hoping to get off the ground,
which to be really fun when we do so. Anyway,
we will certainly keep you posted on that. So you know,
I thought it would be smart to have Justine here
for a number of things. First of all, when one
of the bigger calls. The most major problems we get
when we talk about emergency care is I do my
own emergencies and I take all the phone calls, and
it's amazing how many calls come in and the problem
is my dog or cat got into something. And you know,
it's amazing because we have to know a what is
toxic and what isn't, and not only what presents with
a potentially with a problem, but how much of the ingestion?
Speaker 4: How much does your dog.
Speaker 2: Or cat have to eat to be toxic? For example,
you know I get calls all the time. One of
the more common calls we can get because it has
a bad rap is chocolate. So you know, I think
you have to know, Justine, Why don't you just walk
us through the different types of chocolate and roughly the
amounts that, say a twenty five pounds versus the fifty
pound dog would have to eat to have us worry
whether it's a problem or not.
Speaker 3: Well, first of all, when it comes to chocolate, remember
the darker and the more bitter the chocolate, the more
poisonous it is. And this is actually the worst, one
of the worst weekends for chocolate poisoning with Easter coming up,
so Easter, Halloween, Christmas, all of our holidays seem to
revolve around chocolate, So make sure you keep the basket
out of reach so your dog doesn't get into it.
With white chocolate, white chocolate honestly barely has any real
chocolate in it, so it's not going to be a
problem in terms of chocolate poisoning. If your dog gets
into white chocolate, it would take honestly, dozens of pounds
to cause a poisoning issue. With white chocolate, that said,
your dog will get sick from all the sugar in the.
Speaker 4: Back and white chocolate exactly.
Speaker 3: So when it comes to dark chocolate again, baker's chocolate,
even one ounce can poison a thirty to forty pound dog,
So you want to be really careful. So most of
the milk chocolates that people have, for example, you know
something in the easter basket, depending on the side of
the dog, one or two snickers, one or two little
chocolate eggs aren't going to be a big deal regardless
of the size of the dog. But again it's really
dependent on the size of the dog.
Speaker 2: And how about things like when they say, my dog
ate my chocolate cupcake?
Speaker 3: Oh, great question. So baked goods very rarely have enough chocolate,
and the poisoning concern is theobromine, which is a methyl xantheine.
And again it's not poisonous to us because we don't
usually ingest enough. But there's very very little true theobromine
or true chocolate in baked goods. So again, if your
dog gets a significant amount, even like a tray of brownies,
if you actually look on the ingredients cocoa. It's pretty
low an ingredient list, so thankfully not going to be
a big big deal.
Speaker 2: And so I know they probably get sick from pancrea
tiders for something before the chocolate toxicity by eating all
the fat or whatever in the bake goods. Now here's
another one, you know we have years ago and again
when I think back, what I used to play with
my dogs, and I have labrador and labradors love to catch,
so I would often the favorite thing for them to
jump up and catch and for me to throw at
them were grapes. And all of a sudden, a few
years back whatever we start hearing about the toxicity of
raises and grapes. Clearly, none of my labs either ate
enough or had whatever it was in them that made.
Speaker 4: These grapes toxic.
Speaker 2: What exactly is the problem and why is it the
some dog seemed to be fine and others not. And
just how toxic would for example, a single raisin bee
to a dog who is sensitized.
Speaker 3: Great question. So I also used to kill my childhood dog,
his pregnant zone, his medication in a grape every single
day of his life, and grape and raven poisoning wasn't
actually discovered until two thousand and one, so while humans
have been eating it forever, again, we didn't discover this
until just recently, and so honestly, there's no toxic dose
that we use anymore. It's what we call idiosyncratic. That's
a fancy way for us to say we don't know
which dog is going to be sensitive to it, and
it's not dose dependent necessarily. So some dogs can eat
just a couple of ounces of grapes and go on
a kidney failure. Some dogs can have grapes or raisins
every single day of their life and never have a
problem from it. So my general rule is if your
dog eats one or two raisins, one or two grapes,
or even eats a cookie like oatmeal raisin cookie, it's
probably not gonna be a big deal. But my general
rule is if it's more than a handful, it's going
to be a problem, especially if you have a small dog.
So one of doubt, always call your veterinarian first because
they can give you advice of how to induce vomiting
at home. So there's not going to be any chance
of any poisoning to begin with.
Speaker 4: Now, also another one.
Speaker 2: You know, there are a lot of plants and things
that are out there that people think are toxic. Some
of them are a bit overplayed. For example, you know
points SETI, I think you'd have to eat a bushel
to have a problem, or if it's even toxic at all.
But there is one plant. Well, first of all, we
know there's a plant that really affects cats very very significantly,
and that's lilies, certain lilies anyway, and even so much
is it's true that even the water that the plants
are sitting in, if the cat drinks that water, God,
could be very toxic to them.
Speaker 3: Correct, that's right. In fact, I hate lily poisoning because
my own sister's cat died from it. It died of
kidney failure, and it was a kitten that I had
given her. And so the frustrating thing was her housemate's
boyfriend had sent up a bouquet of flowers and she
just had no idea they were poisonous. So this time
of the year we see a huge fight in the
emergency rooms of easter lily poisoning, and again we don't
know the exact poisons. It still hasn't been chemically identified,
but we know it's water soluble, so one or two leaves,
even the pollen, and like you said, a cat just
drinking out of the water out of the vase can
cause severe kidney failure. Thankfully, the sooner you recognize it,
the sooner and less extensively we can treat it. But
most cats need to be hostileized for at least two
days we can make sure that they don't go into
life threatening kidney failure from it.
Speaker 4: Now.
Speaker 2: Also, one thing that everyone out there needs to know
is that there's a lot of really great As I said,
the Internet is a great source of information, but it's
also a great source of misinformation, and so it's a
good thing if you want to get some background info
going onto the internet, but ultimately you need to talk
to your veterinarian. And here's one that I want to get.
Before I tell you what the internet says, I want
to hear it from the master. And interestingly, I had
two calls this week about the same plant toxin that
I can't tell you the last time we even talked
about it, and I do know it is a toxic plant.
And the question, I guess really became how much would
one need to eat to be toxic?
Speaker 4: And this was oleander.
Speaker 2: Now oleander, there's a cardiac drug that we often use
in practice called digitoxin or digitalist, which is a cardiac
like a side and that is derived from the oleander plant.
But Justine, how much oleander would a dog have to
ingest to get enough toxic effect from the plant itself.
Speaker 3: That's a great question. I guess I'll practice it by
saying that ninety percent of the plants out there just
cause vomiting and diarrhea. And so it's really hard when
you quote unquote stuff on the internet to look for
what kind of poisonous plants there are, because most of
them are considered quote unquote poisonous. But thankfully most dogs
and cats don't ingest enough for it to be an issue.
There's really only one or two plants that will kill
either a dog or a cat, and so for cats
it's definitely lilies, anything in the Lilium or hemorercalis species
like eesulilies or tiger lilies or asiatic lilies. In dogs,
we actually don't worry about oleander quite as much as
we do in horses or even cows or goats or sheep.
And the reason why is oleander is you're right, totally deadly,
but it depends on how much they ingest. So for
a horse or for cow, they would only need to
ingest about ten to twenty leaves or as little as
zero point one pounds of the plant. Thankfully, dogs rarely
chew into this, And honestly, I've been practicing for about
seventeen years, I've never seen an oleander poisoning. That said,
it's deadly, and if you haven't watched the movie White Oleander,
it'll show you how poisonous it is. So Thankfully, we
don't see this poisoning very much in dogs and cats.
It's more of a large animal poisoning that we see.
But I would say, especially since you practiced in California
and oleanders everywhere, even if you see your dogs one
or two leaves, I would still bring them into your
veterinarian so they can be decontaminated and treated right away.
Speaker 4: Gotcha.
Speaker 2: So yeah, I think that I got a call and
the client was concerned. Dog was like, I don't know,
a seventy pound dog and possibly ate eight leaves, and
the internet, you know, basically said, oh my god, you
know you're gonna have a dead dog, you got to
brush them in. I was not as worried, so you
might want to check with your veterinarian first. Now, how
about deefen bakia.
Speaker 3: Great question. Diffen Bakia is commonly known as philodendron, and
it's a really common house plant because it's really hard
to kill. So bailing needs any light, bailing needs any water,
so it's really common in offices and homes, and it
usually grows as a fine. Different bocket is what we
call an insoluble calcium oxalate, and this is where I
see a lot of wrong information on the internet. It
is not a soluble oxalate. It does not cause kidney failure.
So an insoluble calcium oxylate, honestly, it just causes intense
foaming of the mouth. And so there's these microscopic crystals
or what we call wraphites that are in the leaves,
and when you chew on them, that causes intense burning sensation,
so pats and dogs will foam and frost excessively. My
little suggestion is just to make sure to flush out
the mouth. So you can simply do that by offering
some cantun of water, not the oil, but just the
water or even chicken broth to help flush those crystals
out in the mouth. You can give a small amount
of milk or even yogurt and that'll bind with the
insoluble calcium oxylate crystals. And honestly, unless there's more significant
clinical signs like vomiting or diarrhea, or if your dog
or pat continues to boom, most of the time it
can be managed at home.
Speaker 2: Well, that's it's great. So we're gonna take a quick
break here. I want to hear from you guys. Eight
seven seven three eight five eight eight eight two. You
have one of the top in the country sitting with
us here for free. We'll give you advice, So make
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text on internet. Just go on to petlifradio dot com
or you can send me a quick email to doctor
Jeff Drjeff at petlife radio dot com and we will
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Speaker 2: And I want to walk you back do your hair
live with doctor Jeff Werber on Astabets with doctor Jeff
here on pet Life Radio. And we have a very
special guest with us today and that is doctor Justine Lee,
who is double boarded and that means she is very
very knowledgeable the two areas emergency medicine, critical care and
toxicology and that's poisons. And you know interesting before the show,
we were just talking about different things that our dogs
like to do.
Speaker 4: And I have lots of animals.
Speaker 2: I have thirteen and one of my labradors I have
two and this is I mean, he's now thirteen and
he doesn't jump up from many things, but he still
jumps up for this one. And that is that it
sounds kind of gross. So I can see you saying
out there and go, oh my god, this guy's too much.
But when I brush my teeth, you know, we have
that extra toothpaste stuff. And we're talking about MINTI flavors.
How some products with mint some animals like and some
animals don't like. Well, this labrador, he will jump up,
put his front paws right on the sink and he
instead of me spitting out this stuff, you know, of
the foam front the toothpaste, he wants to lick it
right off of my mouth. He is disgusting, but I
let him do it because he likes it so much
and it is his joy in life. And of course
Justine brought up a good point, and that is that
some toothpaste have xylotol. And Justine, because of the many
many products that we find xylotol in out there, I
think people need to know just how potentially what it is,
what is used for, where we find it, and how
dangerous it is.
Speaker 4: Let's talk xylotol.
Speaker 3: Sure, So the most important thing I remember with xylotol
is if you see anything that says sugar free, you
have to make sure that there's absolutely no chance that
there's any kind of xylotol in there. And the main
reason why is because it's super poisonous to dogs when
they get into it. Xylotol is basically a natural sugar
free substance and it basically has no calories. So it's
really popular nowadays in all these products. So we used
to think it was just some gums and mints, but
unfortunates in everything nowadays, So things like chewable multi vitamins,
even pre natal vitamins, over the counter melatonin that's not
even chewable, it'll have a xylotol to have a slight
sweet taste when people swallow it. It's in mouthwashes too, tastes.
It's even in dental floss and nasal sprays. So one
in doubt if your dog choose into anything at all,
make sure you look at the product to see that
xylotal is not in there. Most of the time with
gums and mints, they'll list the order of ingredients in
how they appear. So my little rule is if xylotol
is listed at the top, within the top three to
five ingredients, it's going to be a poisoning issue, one
in doubt. You can always call the company to see
if it's poisonous. You can always call your veterinarian, or
you can call ASPCA Animal Poison Control for life saving invites.
Speaker 4: Also again it shugutless gum. Guys.
Speaker 2: You know, dogs obviously don't chew the gum, but they
swallow it pretty well, so everyone out there. And a
lot of the breast mints and those stuff, you know,
the little containers that you pop in your mouth after eating
because you want that fresh breath. Dogs like that stuff.
As they said, my dog loves minty stuff. So we
got to be very careful that we avoid the xylotol
anything else with Easter anything else, justine that you want
to tell us. Other than we talked about chalcolate, We
talked about some of the plants. What are some of
the other dangers that you expect phone calls come this
next weekend.
Speaker 3: Well, you know, I would say, even though most people
don't think about it, it's actually the easter grass in
an easter basket. So that plastic green state grass that
you put at the bottom of your child's easter basket.
It's basically this long string that poses what we call
a linear form body risk. It's your cat eats it.
So cat flight to chwo on long things because they're
curious the ribbon, yarn, string, easter grass. And what can
happen is it gets stuck in the stomach and as
a stomach or the intestines contract, it can actually stall
through the intestines and cause really severe infections of the abdomen.
So if you have a cat house or even a dog,
absolutely no easter in the basket.
Speaker 2: And also one thing I should mention, speaking of linear
foreign bodies, we call string foreign bodies. And Justine mentioned
just a second ago with xylotol that believe not some
dental flasses. We'll have xylotol because you want that sweet
kind of taste. So what do you do often, you know,
you take your piece of dental floss and you use
it and you toss it in the bathroom trash, which
often is not covered. Cats will love to play with string,
they just really do. That's the old you know, you
can think of the cat with the old ball of
yarn and battling the yarn around. I mean yes, it's adorable,
but when they try to eat this stuff and then
the one part of the string gets stuck somewhere in
the stomach or sometimes around the base of the tongue,
so it can't go anymore. But part of the other
end of the string is coursing through the intestine, and
that causes a terrible problem because then as the string
cannot be passed because it's stuck on something, as they said,
off in the base of the tongue, it has almost
like what we call a piano wire effect, and it
starts sawing through the intestine and it is a major
major problem, often surgical. It can actually be deadly because
once you have a tear in the intestine, that sets
up what we call a paratonitis and it could be
really dangerous. So that's another product you want to be
aware of, is dental flaws or anything that you throw
away in a garbage that is stringing, the ties from
a newspaper, anything, any ribbons. Make sure that your cats
don't have access to those.
Speaker 3: Absolutely. In fact, I say flush it to be.
Speaker 4: Honest, that's absolutely.
Speaker 2: You know. One of the things also we talked about
and I was talking to a client the other day,
we were planning her puppies schedule on when to spay
her dog, and one of the points I made it
was a large breed dog was that to consider, and
again we had some time for her to think about it.
That many of us now are recommending that when we
spay a female, especially because you're already inside the abdomen,
if it's a large breed, deep tested dog, we are
recommending tacking the stomach to the body wall while we're
in the surgery to prevent a deadly condition that is
very possible potential later on in life called GDV or
gastric dileitation volvulus or it's a bloat. What do you
guys think about that, Justine, I think.
Speaker 3: That's so important. So when we quote unquote staple or
tap down the stomach, we're basically surgically just repositioning the
stomach and actually futuring or stitching it to the body
wall so it can't rotate. And this is a must
do if you have a standard poodle, German shepherd, a
great Gain or one of these breeds that has a
really deep chest. I'll even do it in bassetts also.
So this in my opinion, especially when we're saying a
female dog, we know we're going to go into the abdomen.
I think it's really important to do because it could
prevent a really expensive surgery down the line or something
that's deadly. So absolutely, I totally agree with you, doctor Jeff.
It's the way to go for a large breed dog.
Speaker 2: And I think it's very important because if you I mean,
it's one of those things also that when bloat comes on,
it sort of comes on quick and for some reason,
it's not always linked. And this is the I guess
the big puzzle to immediate activity, because I know it happens.
Speaker 4: You mentioned great Danes.
Speaker 2: I mean, I actually get nervous when we board a
great day at my hospital because for some reason why
I don't know, but it seems to happen when they're
even relaxed in in a small run, or they're not
even very active and running around, and it's worrisome. I
can't tell you how many times we've had a dog
that will bloat or stories I've heard of dogs bloating
even when they're boarding and not active, and it's potentially deadly.
Speaker 3: I agree, and honestly, you know, there's been a lot
of studies to look at you know, whether or not
it's exercise related, whether or not it's food related, does
it help if the food bolls elevated. In my general
rule is the more that your dog tants, the more
it's going to swallow air, and that can lead to
the bloating, your stomach filling with gas, and once it
fills so much, it's more likely to rotate. And so
when in doubt, I always tried to be on the
safe side and potentially soak the kibble a little bit
so it doesn't expand rapidly or feed and loose bowls
where it takes your dog a longer time to eat,
especially if your dog wolves down food right away. I
used to try to avoid exercise, you know, fifteen twenty
minutes before or immediately after eating to prevent it. And again,
preventative gastropepsi at the time of the stay is one
of the most important things that you can do.
Speaker 2: You know, I have for two of my five dogs.
I am so impressed with them, I actually sell them
in my office. These no gulp bowls. Basically it takes
the big round food bowl and it has a centerpiece
that comes up dividing the food bowl into four quadrants,
and then each of the quadrants is narrowed at one point,
so the dog cannot literally stick his whole face inside
the bowl and gobble the food in two seconds flat.
I mean to watch my dogs eat, especially the labradors.
You think that they haven't seen food in months, and
if I allowed them, they would probably off a whole
bag at once. So anything that you can do if
you have a dog that is just that fast of
an eater, it would be very wise to look into
some of these bulls. I saw another one that it
forces the dog. The area where they actually can eat
the food from is only a part of the bowl.
The rest is like a it's like a maze, and
they learn to have to paw the food right with
take a paw and roll the food into the one
area that's large enough for them to put their snout into,
so instead of gobbling the food in four seconds, it
takes them about fifteen minutes to polish off their food.
And once they learn how to do it, it's really cool.
I haven't used it yet, but I saw a little
video about it, and I thought that is really clever
because it really slows the dogs down and it keeps
them occupied for at least fifteen minutes while they're trying
to gobble their food down.
Speaker 4: So I thought that was a great idea.
Speaker 3: I think it's idea too. It's great for environmental enrichment exactly.
Speaker 2: It keeps them busy, it keeps them, keeps some ockpie.
And if you have a dog who is suffers from
severe separation anxiety, boy, you can give them some food
in his bowl about you know, fifty to twenties before
you leave it. And they're just they're occupied, They're gonna
let you go there. They're gonna notice you walked out
the door. So anyway, it is that time we have
to say goodbye, call it quit. Justine, Doctor Justine Lee,
I want to thank you for joining me. Anytime you
want to come back, let me know we'd love to
have you. And if you have any questions anything, questions
about toxicities, about emergencies, go ahead and you can email
me at doctor Jeff Dr Jeff at pet Life Radio.
Speaker 4: I will pass them on to Justine.
Speaker 2: You will get your your proceeds product, you will get
your cong toy. And an answer to your question, isn't
life brand What would be worse?
Speaker 4: What can be better? I say nothing could be better.
Speaker 2: So we'll see you back here next week here on
Ask the Bets with Doctor Jeff on pet Life Radio.
Speaker 4: And once again, Justine, thanks.
Speaker 3: For joining us, Thanks for having me on the show.
Speaker 4: Jeff.
Speaker 1: Let's talk pets every week on demand only on petlife
radio dot com.
Speaker 4: What a Boy