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The Daily Vet by petMD

The Daily Vet is a blog featuring veterinarians from all walks of life. Every week they will tackle entertaining, interesting, and sometimes difficult topics in the world of animal medicine – all in the hopes that their unique insights and personal experiences will help you to understand your pets.

Chocolate Toxicity Hits Home

One otherwise uneventful evening, I returned home from a movie to receive an extra enthusiastic greeting from my dog, Cardiff. As usual, we went for a walk outside in our West Hollywood neighborhood to give him the chance to eliminate after being confined inside for a few hours and before we settled in for our night’s sleep.

During our walk Cardiff produced two bowel movements, which is an unusual pattern for him. Most evenings, Cardiff is just a single time pooper and sometimes has to be coerced to do so in the landing strip of his favorite grass in front of our home.

Once inside, I found the paper remnants of an entire 3 oz. bar of Theo Orange 70% Dark Chocolate; consumed by an amped up pooch who eagerly oversaw the process of my discovery. The chocolate bar had been packed in my luggage (as a gift for a friend) in preparation for an early morning flight to NYC for Westminster 2012 (see Notes from the Westminster Dog Show Day 1 and Day 2). I neglected to close the suitcase’s zipper, so Cardiff had ample opportunity to access the tasty treat with minimal effort.

Yes, as a result of my negligence, my own dog had committed a deed which I continuously warn my clients and readers! Had I used proper foresight, this preventable episode of dietary indiscretion would have been averted.

Why am I concerned about Cardiff consuming chocolate? Theobromine, a member of the methylxanthine chemical class (which also includes caffeine), is found in varying concentrations in chocolate. Unlike humans, dogs slowly metabolize theobromine and are more susceptible to toxicity from chocolate consumption. The common body systems that are affected and their associated clinical signs include (but are not limited to):

  • Cardiovascular — increased heart rate and arrhythmia
  • Gastrointestinal — vomiting, diarrhea, and increased water consumption
  • Neurologic — restlessness, muscle tremors, and seizure activity
  • Urogenital — increased urination or urinary incontinence

The highest theobromine concentrations are found in baking and dark chocolate, while semisweet and milk chocolate contain lesser but still concerning levels. Chocolate flavored commercial products and baked goods have the lowest theobromine concentrations. Fat, sugar, and other ingredients (alcohol, preservatives, sugar alcohols, etc.) can also exacerbate the signs of chocolate toxicity.

At this point I elected to stop berating myself about my irresponsibility as a pet owner and to focus on Cardiff’s health. It was obvious that Cardiff had consumed all the chocolate himself (as there are no other pets in the household), but did he consume enough to be toxic?

I checked Veterinary Partner’s chocolate toxicity calculator and realized that Cardiff ate a potentially toxic dose (2.8 oz. for a 20 pound pet). So, Cardiff cooperatively entered his car carrier and off we went to the emergency hospital. Fortunately, I do relief work at this facility and was able to immediately start and direct Cardiff’s treatment.

Here was my plan:

  1. Emesis induction

    I needed Cardiff to vomit (emesis), so he received an intravenous injection of Apomorphine. As it had been hours since he’d eaten dinner, having a stomach full of food helps to promote clearance of undesirable gastric contents. So, I fed him a can of Hill’s Prescription Diet A/D before his ingestion. Within five minutes, Cardiff produced three piles of vomit that had an uncanny resemblance to chocolaty A/D.

  2. Emesis Reversal

    Cardiff received an injection of Naloxone, which partially antagonizes the effects of Apomorphine to reduce the further urge to vomit.

  3. Antiemetic and Antacid Drug

    Cardiff received injections of Cerenia (maropitant citrate) and Pepcid (Famotidine) to further diminish vomiting and reduce his stomach acid level. (respectively)

  4. Activated Charcoal

    This black, thick liquid binds to toxins in the digestive tract to prevent their absorption and facilitate clearance in the bowel movements. The ASPCA’s Animal Poison Control Center recommends not using charcoal containing Sorbitol (a sugar alcohol which facilitates digestive clearance) due to the potential risk of inducing electrolyte abnormalities.

  5. Fluid Therapy

    To promote faster excretion of chocolate’s stimulants through the kidneys and to make up for body water lost through vomiting or potential episodes of diarrhea, Cardiff received a dose of subcutaneous (under the skin) fluids.

Cardiff readily made a full recovery and his appetite was normal the next morning. Yet, he had an increased urgency to defecate and produced softer/darker (nearly black) bowel movements from the activated charcoal for the next 24 hours.

To document the process of emesis induction, I created two videos of Cardiff becoming nauseous and ultimately vomiting:

Cardiff Chocolate Toxicity Emesis 1

Cardiff Chocolate Toxicity Emesis 2

Hopefully, you will learn from Cardiff’s and my experience in dealing with this common and very preventable canine toxicity. I certainly did and feel fortunate that my canine companion was minimally sickened by my parental oversight.

Cardiff at the emergency hospital

Dr. Patrick Mahaney

Image: Cardiff with Chocolate

(My Dear Daily Vet Readers: This photo was staged! No chocolate passed Cardiff's lips — this time!)

Comments  12

Leave Comment
  • Poor Cardiff!
    12/04/2012 07:08am

    Poor Cardiff! He though he'd found a dandy treat.

    Accidents happen to the best of us, but thank goodness you found that he'd eaten the chocolate and went into action immediately.

    Love the "Hector" name tag you're wearing. :-)

  • 12/11/2012 11:19am

    Despite Cardiff's history of having IMHA, he is a very hearty dog and recovered from this unfortunate incident in a flash.
    The name tag and brown forearms actually do belong to Hector and not to me. I was the photographer in this situation.
    Thank you for your comments.
    Dr. PM

  • Yikes!
    12/04/2012 10:15am

    Yowza, my friend. I clicked on this and then got doubly sick when I saw it was Cardiff. Thanks for sharing this ordeal and thank you for being such a continuing source of knowledge and info. So glad he is okay!

  • 12/11/2012 11:21am

    Thank you for your concern and comments.
    I hope that your pooch doesn't face the same talk to exposure like Cardiff!
    Have a safe and fun winter holiday season.
    Dr. PM

  • Chocolate Toxicity
    12/04/2012 12:57pm

    What about the other domesticated species that far outnumbers dogs, i.e., cats? I don't know what the exact numbers are, but I do know that pet cats are the majority group, no longer the minority group.

    Why is it that these blogs seem to almost ignore cats, or only occasionally make some sort of comment that seems more like an afterthought or "throwing a bone" to cat people?

    How about addressing, in this instance, cats and chocolate? Is there some sort of rule that says more than one species cannot be addressed in the same post?

  • 12/11/2012 11:23am

    Good point!
    The vast majority of incidences of chocolate toxicity in pets occur in dogs, although cats are similarly affected by the stimulants in chocolate. In my years of doing emergency veterinary practice, I never treated a cat for chocolate toxicity but have treated more dogs than I can recall.
    Thank you for your comments.
    Dr. PM

  • home based emergency act
    12/04/2012 10:02pm

    Cardiff is such a sweet boy! I had a similar mishap with my 8 pound poodle Bert. He got into my purse and ate 1/2 of a 70% dark chocolate bar. I panicked! But acted quickly, I learned online that household hydrogen peroxide will induce vomiting in a dog. So poor Bert could not understand why mom was pouring this foul stuff down his throat, but soon thereafter he vomited lots of chocolate up, 3 or 4 times. His poor little heart was racing, and I was stroking him telling him, sorry. We followed up with 3 activated charcoal caps and lots of water, which he drank willingly. He ran away into the grass with his tail down and proceeded to poop watery loose yucky stuff, and after that, thank God, he was just fine. He still looks for that chocolate bar in my purse, I guess it must have been worth the trouble, for him. WithSuccessBeBlessed! http://tinyurl.com/bqme58n

  • 12/11/2012 11:26am

    Thank you for your comments.
    I'm glad to hear that Bert was able to vomit up his chocolate and recovered.
    There are instances when having a patch vomit at home after consuming a potential toxin are appropriate, which sounds like the case with Bert. Other times things are more complicated as dietary indiscretion isn't always just a single source of substance that has been consumed. In this case is more invasive measures may need to be taken, such as gastric lavage or diagnostics (x-rays, blood/urine testing, etc.) maybe needed.
    Dr. PM

  • Lip licking video
    12/04/2012 11:12pm

    Thanks for sharing your story. You didn't have to tell the world about your mistake. I've made number of pet guardians errors myself and am reassured that even the professionals' pets can get into trouble.
    The lip licking in the video is all too familiar to me. My dog ate rat poison last year and there are many parallels in the stories.

  • 12/11/2012 11:27am

    Thank you for your comments.
    I think sharing the stories about our successes and failures as pertains to our own personal pets helps to humanize us and makes it seem like we're not just preaching from the soapbox all the time.
    Hopefully, rodenticides will say well out of the reach of both your and my pets.
    Dr. PM

  • toxic ingestion
    12/05/2012 09:46am

    Thank you for this post, with a clear explanation of the nature of chocolate toxicity and its treatment. A vet who posts a video of a dog vomiting on the internet is definitely my kind of person. I watched this, along with my cat,but he was not too interested, preferring to just have his ears scratched. Would there be any advantage to do a gastric lavage under anesthesia? Not being critical, just wondering, thinking about treatment of human patients in the ER. I am glad Cardiff is well. He is a beautiful animal. Accidents may happen. Once, when I was in college, I was going to my parents' house when they were away for a few days, taking care of their cat and giving him some medication which they said they would leave on the table. After giving him a pill, I realized I had given the cat my father's hydrochlorthiazide, obviously forgotten on the trip. I frantically called Poison Control and they told me not to worry about it, just to make sure the cat had plenty of water. There were no problems.

  • 12/11/2012 11:33am

    Thank you for your comments.
    There are instances when gastric lavage is indicated over making a pet vomit (induced emesis).
    If there is an extraordinary amount of caustic substance that is consumed, if a pet is not able to vomit (seizing, non-responsive, etc) or if a more thorough job of removing a deadly toxin is merited, then gastric lavage can be a more appropriate choice.
    You can even infuse activated charcoal through the stomach tube in an animal that is anesthetized for gastric lavage.
    Dr. PM


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