Spring and summer are busy times in emergency practice, and there have been many distractions keeping me from my blog. The biggest has been sleepiness – you can only be sleepless for so long before the brain starts to slow down and demand rest. So that is what I am currently trying to do, catch up on some sleep and enjoy a rest by the seaside.
I started thinking about some of the issues we might face by the seaside. Of course at this time of the year, there is always the threat of snakes when wandering through bushland on our way to the water’s edge. Pet emergencies can truly happen anywhere and dogs should always be supervised. The beach is no less of a threat.
A doggy day out at the beach can easily end in a visit to the emergency room. Dogs eat sand, drink salt water, try to tackle pounding waves (sometimes nearly drowning in the process), and occasionally they encounter nasty creatures such as the blue-ringed octopus, jelly fish, toxic shellfish and for some reason, the doggy favourite, puffer fish.
Puffer fish (also toad fish and blow fish) are a delight for dogs to try – the stinkier the better! According to a Western Australian Government Dept of Fisheries fact sheet (http://www.fish.wa.gov.au/Documents/…fishing/fact…/fact_sheet_blowfish.pdf), they are the second most poisonous vertebrates in the world. Of course we have them here in Australia! They are members of the family Tetraodontidae and they carry a poison in their skin and internal organs called tetrodotoxin. Tetrodotoxin is liberated by bacteria in the fish’s gut, the toxin then being absorbed into the blood and heading toward the liver and skin of the fish. It is not toxic to the fish themselves, but is a useful defense against predators. Consequently, for most dogs that just taste the fish, the signs of toxicity may be minimal or non-existent, but for those who eat the whole fish, the result can be fatal.
The toxin is a neurotoxin (affecting the nervous system) and blocks nerve conduction, particularly in the heart and brain. Signs of toxicity often begin with gastrointestinal signs such as vomiting and/or diarrhoea. Vomiting can be very helpful and may aid in eliminating the offending agent and providing a diagnosis. Other signs that may develop include tremors, hind limb weakness/ataxia, breathing difficulties and occasionally seizures. Without appropriate supportive care, death occurs from respiratory paralysis and cardiac failure. Neurological signs can take 1-4 hours to develop, so pets should be closely observed if they eat unknown objects from the waterfront.
There is no antidote to tetrodotoxin paralysis but it can be effectively managed with seizure control if indicated, assisted ventilation and cardiovascular support. The toxin generally wears off over 24 hours following exposure provided appropriate supportive care is instituted. Most dogs will return to full and normal function as though nothing ever happened. And so they can run back to the beach, where you may have to watch out for a second problem!
It is one of those unfortunate conditions where an unexpected crisis may result in either death or a hefty veterinary bill. Another reminder of the benefits of pet insurance. I will endeavour to write more on summertime ills in the next few weeks, till then, I plan to catch up on some more sleep!