Topical Toxins

Our inquisitive dogs and cats can come into contact with or ingest common creams, ointments and transdermal patches. This article will explain some of these common creams and ointments, the symptoms to look out for if your pet ingests these and what to do if you think your pet has been poisoned.

Topical steroid ointments/solutions

Corticosteroid ointments and solutions are frequently used by both people and on animals. Hydrocortisone, Betamethasone and Triamcinolone containing products are well known preparations to a lot of people. If you pet ingests any creams or ointments containing the above, toxicity is unlikely.

Symptoms to watch out for:

Mostly mild vomiting or diarrhoea is a result of consuming these products. Some animals will have a temporary mild increase in drinking and urinating.

Sunscreen and Nappy rash ointment (Zinc Oxide)

There are many products that contain zinc oxide, from nappy rash to UV protection creams. Depending on the concentration (5 – 40%) and amount of ingestion symptoms may develop.

Symptoms to watch out for:

Vomiting is the most frequent symptom but also diarrhoea may develop. If symptoms progress from mild to severe then symptomatic and supportive treatment may be required. If this occurs, please call your local vet immediately.

Antibiotic Ointments

Topical antibiotic ointments commonly used often contain Neomycin, Bacitracin and/or Polymyxin.

Symptoms to watch out for:

Signs of acute ingestion can be vomiting and diarrhoea due to the petroleum based carriers or due to imbalance of the gut flora. Symptoms are usually self-limiting but depending on severity need may need supportive treatment, this means you should call your vet if these symptoms occur.

Nicotine patches

These transdermal patches are designed to release Nicotine slowly. If an animal chews them there may be a much quicker release. Patches will also contain more Nicotine then they will normally release, so when chewed may pose an even greater toxicity risk.

Symptoms to watch out for:

Signs of Nicotine intoxication can be salivation and vomiting. Things can progress to more systemic problems with increased heart rate and breathing, dilated pupils, tremors and even seizures. With even longer and more absorption of Nicotine neurological depression, seizures and even death can occur.

If the patch is still suspected internally then action should be taken to remove it.

Needless to say, that if there is a suspicion if chewing/ingestion of a Nicotine patch a vet should be consulted as soon as possible.

Treatment is symptomatic and supportive as there is no antidote available.

Tea Tree Oil (Melaleuca)

Tea Tree Oil can be found in lots of products like shampoo, lotions and ointments. Most products will not lead to toxicity as they are quite diluted. Intoxication usually only occurs when 100% oil is used. The oil can be absorbed through both the skin and the gastrointestinal tract. The oil is rapidly absorbed through the skin and gastrointestinal tract.

Symptoms to watch out for:

Toxicity can include weakness, ataxia, hypothermia, tremors and depression.

Unfortunately, there is no antidote so treatment is supportive. It is usually initiated with removing the oil with a degreasing soap. Activated charcoal can be given if ingestion is likely. Intravenous fluids are given to pet’s and maintaining normal body temperature is important as part of the supportive care. There will be continuous monitoring for a couple of days of vital signs, hepatic enzymes and serum electrolytes. Therefore, it is important to visit a veterinarian quickly if your pet ingests tea tree oil.

Fentanyl patches

Fentanyl patches are transdermal patches to administer a controlled amount of this opioid painkiller. It is related to morphine but is much more potent. The patches contain an amount of Fentanyl that when chewed on can be released quite rapidly. Also patches that have been used can still contain a high amount of Fentanyl.

Symptoms to watch out for:

In dogs signs of toxicity are usually sedation andCNS(central nervous system) depression, depression of heart and respiration, narrow pupils and hypothermia. In cats there can beCNSdepression or stimulation and wide pupils.

If the ingestion of the patch was fairly recent, the veterinarian may induce vomiting or remove the patch via surgery or endoscope. In cases like this, removal of the patch should always be attempted. With CNS depression, treatment can be started with an antidote. Sometimes seizures need to be controlled. Supportive care and sometimes supportive breathing needs to be provided to your pet.

Calcipotriene cream

This a vitamin D cream used for the treatment of psoriasis. Ingestion can lead to life threatening hypercalcemia and hyperphosphatemia that will cause renal failure and, less likely, cardiac failure. Cats are more sensitive to this toxin than dogs.

Symptoms to watch out for:

Signs include increased drinking and urinating, vomiting, lethargy, blood diarrhoea, blood in urine and death. Treatment is supportive and an attempt to correct the hypercalcemia with medication.

Salicylate cream

This includes creams used to treat acne, psoriasis, ichthyoses, and warts etc that contain salicylates (ASA). There are Aspirin salicylates and non-aspirin salicylates.

The toxicity is measured in Aspirin equivalents. Depending on the amount of ingestion symptoms will develop. Cats are more sensitive than dogs to Aspirin intoxication.

Symptoms to watch out for:

Clinical signs will develop hours to days after ingestion. Vomiting, sometimes with blood and diarrhoea with blood are the most common signs. Signs can progress to hyperthermia, collapse, tremors, seizures and depression. Aspirin influences clotting of blood and is an inhibitor of Prostaglandin production. Treatment is focused on removal of the ingested cream, gastro-intestinal protection and supportive/corrective measures. In some cases, a blood transfusion may be needed.

Depending on the amount ingested and signs treatment for this can be quite intensive.

5-Fluorouracil cream

Fluorouracil is used in the treatment of keratosis (actinic) and superficial basal cell carcinomas in people.  It has an effect on the synthesis ofDNAand processing of RNA. Cats are sensitive to 5-Fluorouracil and there is a very narrow safety margin if ingested. When a dog or cat chews into a tube this is always considered an emergency!

Symptoms to watch out for:

The most common signs of intoxication are vomiting, seizures and tremors. Death can occur 1-5 hours after ingestion, so it is very important to seek veterinary attention immediately if you think your pet has ingested this. Other signs may be abdominal pain, diarrhoea, other GI problems due to ulceration,CNSsigns and cardiovascular problems.  Treatment is aimed at seizure control, supportive therapies, and gastrointestinal protectants. Hospitalisation and aggressive therapies are indicated to bridge a recovery period of 2-3 weeks.

Insecticides (Pyrethrins and Pyrethroids)

These are commonly used and found in topical insecticides. Most products that contain them like sprays and shampoos have a low concentration and will not likely lead to toxicity. Cats are more sensitive to this insecticide than dogs. The most common intoxication is via a dog spot application with a pyrethrin/pyrethroid based insecticide. Applied on the skin of a cat or indirectly by grooming the dog that had the application are the likely causes of intoxication.

Symptoms to watch out for:

Signs of intoxication include hypersalivation, vomiting, hyperexcitability, twitches, tremors, dyspnea, weakness, disorientation and seizures. Treatment should be directed at removing the application on the skin and treatment to control seizures. Supportive therapy is often necessary but the outcome is usually excellent.

If you think your pet has ingested any of these dangerous toxins, please contact the North West Animal Hospital on (03) 6424 9888.