The American Society for the Prevention of Cruelty to Animals (ASPCA) has an Animal Poison Control Center (APCC) which consists of a team of 163 veterinary professionals, with 22 board-certified veterinary toxicologists. The APCC is a 24-hour-a-day, 365-days-a-year hotline resource for pet owners and veterinarians nationwide in keeping animals safe and healthy. In 2023, the APCC team helped more than 400,000 animals from across all 50 states with toxicology cases.

 The ASPCA has compiled data from these cases and is now highlighting the most prevalent toxins in an effort to raise awareness during National Poison Prevention Week (March 17-23).

The APCC’s top 10 toxins seen in 2023 include the following:

Human food and drinks (protein bars and drinks, grapes and raisins, and items with xylitol)

Household products like cleaning supplies

Recreational drugs (marijuana, hallucinogenic mushrooms, and cocaine)

This is the tenth year in a row that human medications lead the top toxin list for APCC with OTC human medications making up nearly 17% of the APCC's total call volume for the year. Recreational drugs first made the top 10 list in 2022 knocking out gardening products. The APCC team reported a 74% increase in call volume related to hallucinogenic mushrooms when compared to the year prior. Overall, the items on the top toxin list made up more than 96% of the APCC's total call volume in 2023.

"Veterinary experts at the ASPCA Poison Control Center see a steady increase in call volume each year, which reflects an increased recognition of items that pose a potential risk to pets," said Tina Wismer, DVM, DABVT, DABT, senior director of toxicology, ASPCA APCC, in an organizational release.

 "The APCC has been a trusted resource for pet owners and veterinarians across the country to assist in emergencies involving toxic ingestions and exposures for more than 45 years, and we continue to position ourselves as the leader in veterinary toxicology to save more animal lives."

For chocolate, the main concern comes from the methylxanthines theobromine and caffeine levels

 and theobromine concentrations in chocolate vary based on the type of chocolate, with unsweetened, baker’s chocolate, and 100% cacao products containing the highest content, followed by semisweet and dark chocolate. Milk chocolate contains lower amounts of theobromine, and the theobromine content of white chocolate is minimal.

Xylitol may be found in a wide range of products including chewing gum, candy, mints, sugar-free foods as a sugar substitute, toothpaste, mouthwash, skin lotion, deodorant, and more.

As the No. 2 spot on the APCC list, other human foods to be wary of besides xylitol, protein bars and drinks, and grapes and raisins, include onions, garlic, macadamia nuts, and large quantities of avocado.

More than 400,000 animals assisted by ASPCA Animal Poison Control Center in 2023. News release. American Society for the Prevention of Cruelty to Animals. March 5, 2024. Accessed March 21, 2024. https://prnmedia.prnewswire.com/news-releases/more-than-400-000-animals-assisted-by-aspca-animal-poison-control-center-in-2023--302080150.html

Hovda LR, Brutlag A, Poppenga RH, Peterson K, eds. Blackwell’s Five-Minute Veterinary Consult Clinical Companion: 

Schmid R. The most common poisons for pets. 

. March 21, 2024. Accessed March 21, 2024. https://www.dvm360.com/view/the-most-common-poisons-for-pets

Articles

The ASPCA spreads awareness for National Poison Prevention Week

Animal welfare group reveals top toxins from 2023

Specialty care

Yeah, I love it. And Dr. Penn, I know you're out on the field, too. And what are some of those hesitations that are out there that some veterinary practices may have? What are some things that you chat with them to say, hey, there's some things to consider?

Yes, for sure. You know, when we think about in-house diagnostics, I think CBC and chemistry. I think veterinary professionals, you know, we understand that we're trying to help with efficiency. We're trying to help with consistency and getting those results fast. When we think about the VetScan Imagyst, and we think about artificial intelligence, you start to start to get a little more concern around the artificial intelligence. And maybe that's a little bit scary and is the VetScan just here to take my job. And the truth of the matter is, the VetScan Imagyst is just there to complement a veterinary staff. It is meant to provide us consistent, thorough results that allow us to gain back efficiencies with our everyday. We know that we're seeing, you know, tons of patients every single day as veterinary professionals. We're worked really hard. we want the highest standard of care. So, this is really complementing our veterinary staff, and it's giving us access to experts to be able to say, hey, if I want to send this sample and have a clinical pathologist read this out, I have that availability to get that result back in hours. So, I think the biggest thing is this artificial intelligence. You know, it is validated against experts to provide that expert level results. It's backed up by experts. And it's there to complement, not to replace anyone.

I like that a lot. And our last closing thoughts. So, I'm going to ask all of you on this too, what would you say to anyone out there that's tuning in, that they're considering it? And what would be, you know, how would they overcome that challenge to take that leap of faith, if they wanted to switch to Zoetis diagnostics?

Embrace the change because it's here, and it'll help you practice, and it'll save you time. That's the other thing, too, it's like you said. If I can save 10 minutes every hour, I can...it's just a lot better quality medicine.

I think one of the big aspects of what we're trying to provide is customizable care and quality care. And so, I think, though, this is taking that extra step to really provide a holistic process that's allowing us all to practice better. And I think that's the buy in, that we really can all do better together.

Yeah, I agree with that. Accept the change, you not only embrace Zoetis, you gain a family behind you. You're a team. Everything we've done has been such a team effort there. And they've made it as smooth as can possibly be. And it's helped us as a business grow economically as well. We have been able to free up technicians, as this equipment is now doing what they might have done for us. And we've also been able to keep it consistently, especially in a multi-doctor practice where you have 14 doctors to stay consistent, because you might not always see rechecks, but you can have some consistency, issues with multiple doctors. So, it's been a very smooth change.

Yeah, I think it's just an amazing partnership for the profession to really, you know, ultimately provide that individualized, specialist access type care. That maybe as a general practitioner, sometimes we feel on an island, and we're not on that island anymore. And we do have that access. And I think that to me is just absolutely amazing and helps in the current landscape of veterinary medicine. It really helps us in regard to easing off all the pressures that we feel every single day.

I love that. You know, I always said that, you know, we're all VIPs. We all want to be treated like VIPs. But the new ”I” is individualized care. You know, we want very individualized care for our clients and pets. And it sounds like that's what we're doing here, and I love that. This is wonderful. Well, Dr. Penn, Dr. Wolfe, Dr. Hann, Dr. Clary, thank you so much for joining us on this great panel discussion. We also want to give a big shout out to our friends at Zoetis for supporting this episode and all the content that you've been seeing with these past few episodes. Thank you so much for tuning in. On behalf of dvm360, Dr. Adam Christman here. Thank you so much and we'll see you next time right here on Pet Connections.

Videos

Experts explain how Zoetis Diagnostics can increase practice revenue, improve workflow, and provide better quality care

Consistent, Individualized and Quality Care

Welcome back. In this episode, we're gonna be talking about making the change in practice and Dr. Clary, we know that change can be scary to all of us, the veterinarian and the team. So, what was the change like for you from switching to the Zoetis diagnostics? And how did you and your team overcome any fears?

Zoetis was incredible. We used to just have in house labs, and that was it. We just had in house labs. And now with Zoetis, we have I feel like a team behind us that supporting us, and everything we do, whether it’s just a CBC, you know, reading that, to the Imagyst, to the specialist. I feel like we’re just taken care of by Zoetis better than any company we’ve ever dealt with. And it was mind blowing. And it was, we lost a lot of sleep, Dr. Wolfe and I…Now we had a lot of talks. And it was a huge commitment. But it was a commitment we wouldn’t look back at

Dr. Wolfe, what has it been like for you?

I'll just reiterate what he said. We've been through a lot of changes where private practice to corporate practice to opening up a practice in a second, to paper records to digital records, do a digital whiteboard, and also changing from one practice software to another. And so, we're used to change, but we also understand what comes with it in regard to the stress on the on the team. And this was one of the smoothest we've ever had. Zoetis just made it...just kind of went pretty overnight and very smooth and was probably one of the smoothest changes Clary and I have experienced.

By far the smoothest transition we've ever had.

And how did you get the team to buy in because that's important, to get them on the same page. What was that, like?

Zoetis was incredible in the people that they brought in to train our staff. When they left, the staff knew more, way more than I know how to run those machines, which is fine. I don't need to run a CBC. I want somebody to do it and give me the paper. And it was incredible. And they felt like they did a better job than by far than anything else we've ever done. Like we've changed a ton and I'm starting to embrace change because it means my practice is growing. I'm growing as a veterinarian; we're just getting better. And this has been probably the best addition we've done to for our pets. Another thing we haven't talked about as much is access to a specialist is incredible. But also at the price, it's even more incredible. You know, and with better medicine being the price that it is right now, anything we can do to hold down prices for our pets, they get better quality care.

And Dr. Wolfe, what was that like for you?

Yeah, you know, buy in is...we have 14 doctors. And although Dr. Clary and myself and our other partner make the decisions, we have to have them buy in. And I think the thing that stands out is anytime you're on anyone from Zoetis, you know they have a servant's heart. They are there to help you. They are highly educated. I've talked to so many people that have just astounded me at how smart they are. And from all levels. And you can tell they have a servant's heart. They're there. And as Dr. Clary said, they're teaching them not only how to run the machines, but they took it back, they took it back to actually sample collection, because once you put sample you provide to the machine determines that results. And so they even taught our team, you know, different ways...different position sizes. They made sure that our team knew that, but not only they knew that, they understand it. And so, I think for our team, they all bought in really pretty quickly because they could sense that Zoetis cared for us and for our clinic and for our patients. And we're going to support them through that process. And so, they bought in very, and I think they understand that they also see the value in, for example, the Imagyst just in the quality of diagnostics there. So, for example, we've had this for about a year now. And so, the Imagyst to is introduced new...originally it was fecal. We didn't have skin cytology, and actually had an opportunity to meet the individual who designs the software for the Imagyst. I met him and he just spoke with me. You're a veterinarian; what do you need? What kind of software can we provide in an order for you to utilize our software? What do we need it to do for you? And so, we talked about we needed it to work quickly there. And so, our team has seen as well that that this is growing too. This is growing more. And more software hopefully over the years is going to be introduced to the Imagyst. Which is going to...the sky's the limit, I think.

Two veterinarians share how they switched to Zoetis' in-house analyzers and Virtual Laboratory, which was a smooth and easy transition for their practice and their team

Making the Change to Zoetis Diagnostics with Ease and Confidence

Veterinary visits can be stressful for both pets and their caregivers.

 This is particularly true for cats with their unique behavioral needs.

 Although it is unrealistic for veterinary visits to be completely free from fear and anxiety, implementing proper handling strategies can help minimize injuries, significantly reduce stress, and enhance both the comfort of feline patients and cooperation from their caregivers.

Recognizing the protective emotions of fear, anxiety, frustration, and stress that cats may experience during veterinary visits is important.

 A cat’s behavioral responses are a direct indicator of their emotional state.

 By understanding these emotional responses, the veterinary team can adjust their approach to each individual cat, thereby reducing stress and avoiding escalation towards a more dangerous defensive response.

 Instead, use objective terminology such as ear position, pupil size, tail position, body positioning, and more to describe body language.

 Descriptive observations help to identify the true emotional state of the cat and the subsequent behavioral response.

Be sure to educate clients about what is being observed.

 By doing so, empathy is more likely to occur, which then leads to a higher level of comprehension about the true motivations behind behavioral responses and improved adherence.

To reduce feline stress in clinics, use species-specific pheromones and provide a cat-only entrance and waiting area.

 Separate appointment times or days for cats and establish a dedicated “cat-only” room that is regularly cleaned to reduce potential presence of pheromones left by other stressed patients.

Soundproofing, door draft protectors, and playing cat-friendly music helps to minimize outside noises and create a calmer environment.

 Stock the room with all necessary equipment and supplies, including a litter box, fresh water, toys, syringes, needles, butterfly catheters, blood collection tubes, and portable ultrasound for guided cystocentesis.

Recognizing that cats are often stressed by movement and changes in their environment, therefore, limit the frequency of entering/exiting the room.

 Avoid separating cats from their caregivers unless absolutely necessary. In cases where removal is required, consider asking the client to wait just outside the door instead of removing the cat.

In cats, protective emotions can often be triggered by environmental changes such as movement, noises, smells, and touch.

 To prevent startling them, approach with low voices and slow movements.

 Interactions should never be forced; the cat should have the opportunity to choose when and if to engage.

 Begin petting with a gentle massage at the temples or chin. Avoid petting or stroking down the length of their back, and never tap on their head as a distraction technique as many cats find this aversive.

During the history taking process, place carriers on the floor, open the door, and let cats exit to explore at their own pace. Do not pull, shake cats, or otherwise force cats out of carriers. Start the initial exam from a distance to check mobility and look for signs of disease, such as discharge or hair loss.

Examinations should take place where the cat feels most comfortable.

 Begin with less invasive methods, like auscultating the heart and lungs, before proceeding to abdominal palpation and later, examining the ears, eyes, and mouth. Avoid or postpone temperature checks, premedicate for pain before examining painful areas, and sedate if needed.

 Use minimal handling and observe the cat’s body language throughout the entire process.

Warming towels infused with pheromones can offer cats a sense of security, allowing them to hide if they choose.

 Allowing a cat to stay in the lower half of their carrier, beside their caregiver on a bench, on the scale, or perched on a countertop can help minimize stress.

 When handling is necessary, familiar cues such as touch, sit, and place, and food distractions should be used first.

 Manual manipulation and methods like scruffing or full-body restraint should be avoided, as they can be painful, induce stress, and may trigger protective emotions.

When restraining, avoid using tight towel wraps or commercial cat wraps.

 These methods restrict the cat's ability to make choices, such as the ability to move away.

 Although a cat may outwardly seem fine or compliant, they often are not.

 Cats restrained using these tools and techniques may be just as fearful as those displaying more aggressive behaviors but express their fear through immobility and emotional withdrawal.

 This is often evident in their facial expressions, ear positions, and body tension.

Depending on the individual cat, certain medical procedures, such as venipuncture, blood pressure measurement, cystocentesis, abdominal ultrasound, or radiographs, may be perceived as more invasive or stressful.

 Keep in mind that most cats prefer a semi-lateral position and should never be forcibly placed in dorsal or full lateral recumbency.

Employing handling techniques that adhere to Low Stress Handling principles requires skill and patience.

 However, these techniques focus on the cat's comfort and willingness to participate in the examination process.

 By avoiding a forceful restraint, cats are more likely to stay calm and cooperative.

The use of cat muzzles is not a recommended handling technique. Muzzles restrict a cat’s ability to receive and interpret sensory input from their environment, which can result in distress. The use of muzzles can elicit a similar emotional response, withdrawal and immobility, as scruffing, tight towel wraps, and commercial cat wraps. Additionally, muzzles may cause pain or discomfort, particularly because of pressure placed on the cat’s highly sensitive whiskers.

Additionally, gloves are not recommended for handling cats, except in specific instances where there is an immediate human safety concern during the sedation process. Even then, alternatives, such as a warm, pheromone-infused towel or blanket loosely wrapped or draped over the cat or administrating sedation while in a carrier should be considered.

If muzzles or gloves are deemed necessary for safety, sedation is the preferred method.

 The focus should always be on the cat's welfare, clear communication, and preserving the cat’s ability to make choices such as moving away.

 The same is true for other restraint devices such as Elizabethan collars and air muzzles.

Pharmaceuticals, including sedation and previsit medications, are significant components of Low Stress Handling techniques.

However, it is essential to understand that pre-visit medications are not a green light for conducting a physical examination or performing diagnostics.

 Instead, their main purpose is to reduce the onset of protective emotions such as fear, anxiety, and frustration, as well as the associated stress response thereby facilitating a more relaxed state in preparation for sedation.

 Therefore, it is important to assess the urgency of each procedure and to prioritize sedation as “Plan A” rather than an afterthought.

 When selecting medications, treat each patient as an individual, stopping all handling at the earliest indication of distress.

 Depending on the urgency, a choice should be made to either reschedule or proceed with sedation.

The initial contact between the hospital and the client can influence the entire veterinary visit. Customer service representatives (CSRs) should check the patient's medical records for an individualized handling plan to help keep stress to a minimum from the moment an appointment is made. Visits should be scheduled during quieter times of the day, such as the first or last appointment, and, if possible, arrange for the patient to see team with whom they have previously had positive interactions.

In addition to scheduling, CSRs should identify the need for pre-visit medications and coordinate with the veterinary team to ensure these medications are prescribed and ready for the client to pick up ahead of the visit.

 Once an appointment is scheduled, the veterinary team should be briefed on the patient's individualized handling plan, with a note attached to the appointment in the schedule.

Education is a cornerstone for the successful implementation of Low Stress Handling, a training program that teaches the humane animal handling techniques mentioned in this article.

 These techniques help professionals recognize escalating emotional arousal through the observation of their patients’ body language and to understand the significance of physiological changes associated with a stress response.

 Through regular practice, the veterinary team can develop and refine their skills, learning how to make appropriate adjustments for each individual patient, which promotes the most humane approach centered around the comfort level of their feline patients.

Cooperative care training combines training and behavior modification to improve communication and predictability.

 Positive reinforcement is used to condition cats to their carrier and foundational behaviors like targeting, including stationing, chin rest, paw, and nose touches.

 Once cats become proficient, these “start button” behaviors enable them to signal their readiness to proceed or to request a pause, replacing defensive behaviors such as growling, swatting, hissing, and biting. Effective training requires reinforcing both options, clarifying to the cat that choices exist and that their decisions will be honored.

Once proficient at offering these behaviors, both at home and subsequently in the veterinary hospital, the next steps are desensitizing and counterconditioning with respect to injections, handling, positioning, and other procedures.

 Although starting early in life has its advantages, this training is beneficial at any age.

Author Christine D. Calder DVM, DACVB, LSHC-S, is a veterinary behaviorist at Calder Veterinary Behavior Services, based in New England.

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Snowdon CT, Teie D, Savage M. Cats prefer species-appropriate music. 

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Yin, S. A. (2009). Low stress handling, restraint, and behavior modification of dogs & cats: Techniques for developing patients who love their visits. Cattledog Publishing.

Arrandale L, Buckley L. Towels versus hides: which are best at reducing acute stress in the newly hospitalised domestic cat (Felis sylvestris catus)? 

Westlund K. To feed or not to feed: Counterconditioning in the veterinary clinic. 

Moody CM, Dewey CE, Niel L. Cross-sectional survey of cat handling practices in veterinary clinics throughout Canada and the United States. 

Moody CM, Mason GJ, Dewey CE, Landsberg GM, Niel L. Testing two behavioural paradigms for measuring post-handling cat aversion behaviour. 

Moody CM, Mason GJ, Dewey CE, Niel L. Getting a grip: Cats respond negatively to scruffing and clips. 

Moody CM, Picketts VA, Mason GJ, Dewey CE, Niel L. Can you handle it? Validating negative responses to restraint in cats. 

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Shenoda Y, Ward MP, McKeegan D, Fawcett A. The cone of shame: welfare implications of Elizabethan collar use on dogs and cats as reported by their owners. 

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Barletta, M., & Raffe, M. Behavioral response and cost comparison of manual versus pharmacologic restraint protocols in healthy dogs. 

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https://cattledogpublishing.com/why-and-what-is-low-stress-handling/

Pratsch L, Mohr N, Palme R, Rost J, Troxler J, Arhant C. Carrier training cats reduces stress on transport to a veterinary practice. 

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The author shares tips for practicing feline medicine while mitigating fear, anxiety and risk of injury 

Enhancing well-being by minimizing stress 

Jennifer Bruns interview

Sponsored by PetSmart Veterinary Services

While attending the 2024 Fetch dvm360® Conference in Charlotte, North Carolina, Dr. Jennifer Bruns, DVM, MPVM, explained how to chart a new course in life, like becoming a veterinary practice owner. As an exercise for the audience, she asked them to pick a candy bar. “You make those decisions based on what you know already today. So, you’ve eaten those candy bars before. Maybe you like a certain part of a company’s advertising or there’s something ingrained in you that really works,” said Bruns. If someone opted out of a candy bar because they brought a dessert already, Bruns claimed it to be an easy decision. However, that same ease doesn’t always apply to bigger life decisions.

There may not be a frame of reference to know exactly how some decisions will work out. Not knowing can create decision overload and leave doctors staring at the various pathways before them. Do they want to continue what they’re doing right now? How do they bridge their experience to the next big thing? It is common to get stuck in this step and not look at data-driven information.

Bruns set up for the audience a thought exercise of being in a boat with everything you have—family, pets, career, hobbies, etc. If they were then forced to start throwing things out of the boat or otherwise sink, what would they do? This approach is tough when it comes to family or kids or pets, but it forces oneself to ask what in their world aligns with their current values.

Each finger can represent different elements of a decision. Bruns started with the pinky as a reminder of values. The ring finger makes you ask if you’re doing what you love or if you’re compromising. Being the tallest finger, the middle finger is the leader. As the pointer finger, the index finger lets you think about who can guide and provide you with the information you need. The last finger is your thumb which points back to you. “One of the greatest things about practice ownership is that it’s your business, you’re the one that owns the results. But you’re the one that also reached all of the rewards, all of your hard work,” encouraged Bruns.

According to the AVMA report on the economic state of the veterinary profession, being a practice owner drives higher levels of happiness and mental health in veterinary medicine. “Sometimes we're so worried about the work that we have to put into it that we don't realize there's a big upside,” said Bruns. Aside from financial changes and flexibility in one’s work, owning a practice increases compassion satisfaction versus fatigue or burnout. There is a greater sense of personal satisfaction in one’s work and that translates to their life and clients. When you’re an associate, you have to follow your boss even if that doesn’t align with your goals.

While becoming a practice owner means a lot of change, there are resources, like with PetSmart, to make it easier. “I do wish you all the best regardless of what your journey is and what you're thinking about,” concluded Bruns.

Understanding various approaches to making career decisions as a veterinarian

Made of choices

Lacey Rosenberg, DVM, DACT, explains the many causes and best management practices of dystocia

An overview of dystocia from a theriogenologist

In an interview with Lacey Rosenberg, DVM, DACT, an associate veterinarian for Veterinary Specialties at the Lake in Sherrills Ford, North Carolina, she explained what can cause dystocia, a birthing complication, and her expertise in managing this condition during the Fetch dvm360 conference in Charlotte, North Carolina.

 Dystocia basically is difficult labor or difficulty giving labor in small animals. There's thousands of different causes, but most of the time, what we're gonna see is stuck puppies, uterine inertia—which is where the uterus just isn't contracting appropriately from the get go. Or what we call secondary uterine inertia, which is where a female has had a certain number of puppies and just gets exhausted. We can see metabolic problems that can cause dystocia, like hypocalcemia or hyperglycemia, pregnancy toxemia, lots of different things that can cause it.

Managing dystocia [would start with] getting a really thorough history, confirming that the patient actually has a dystocia, and then usually, we have to be very cautious with medical management. So really making sure that it's an appropriate candidate for medical management [and] that we have a decent chance of success with medical management.