Hot Chocolate!

It's one of the most common toxicity emergency calls we get -- "My dog ate chocolate!" But rarely does the pooch eat high quality chocolate or a large enough quantity for it to be a problem. The primary toxic ingredients in the best chocolates are high levels of theobromine and caffeine, which can cause vomiting, diarrhea, heart palpitations and arrhythmia, tremors, seizures and even death.  Unsweetened cocoa and baking chocolates are the worst kitchen culprits with a few ounces being toxic for 40-lb dog. However, I've met plenty of huge hounds who inhaled bags of less toxic milk chocolate (foil wrappers and all) resulting in agitation and vomiting.

Late last week, we got the standard "my dog ate chocolate" call about a 10-year-old dog who knew how to open the pantry cabinets. Besides eating 14 bars of high-quality dark chocolate (what a waste!) Zuni shredded and nibbled jello boxes, bouillon cubes and various other items. Based on Zuni's weight and the amount and type of chocolate ingested, we quickly determined this was a real problem! At our instructions the owners administered hydrogen peroxide to induce vomiting, but Zuni didn't produce anything until the car ride into the clinic. The few small piles of vomit smelled purely of rich warm chocolate.

Zuni's examination fortunately was fairly normal aside from a bloated appearance, some trembling which we determined was due to nervousness and a mild heart murmur of which we have yet to determine the significance. We decided to induce vomiting again since Zuni's stomach was still quite distended. The more chocolate we can get out within two hours of ingestion the less toxicity we will have.

Dr. Kim Everson walking a chocolate-eating
dog outside with piles of steaming hot
chocolate vomit visible in the snow.

Rather than repeat hydrogen peroxide, we administered a more potent emetic -- a derivative of morphine -- into the corner of Zuni's eye. (Weird, I know.) Within 10 minutes, Zuni looked pretty unhappy, drooling and swallowing hard with nausea. We rinsed the medication from her eye and applied eye drops to soothe the redness. I took her outside for a little jog to jiggle her stomach contents and Eureka! Zuni produced one large pile of steaming hot chocolate after another, five prodigious piles in total scattered in the January snow.

Once it was clear that her stomach was finally empty, we returned to the examination room crowing with victory. (Well, I was crowing. Poor Zuni felt pretty miserable, her joy in devouring a cabinet full of groceries finally subdued.) Our decontamination task was not yet complete, however. Next we administered activated charcoal to bind up the theobromine and caffeine still in her GI tract. The owners were instructed to repeat this at home every couple of hours throughout the night and into the next day.

The owners were also advised to monitor for neurological symptoms but especially diarrhea in the coming days. Any residual wrappers are expected to wad up and pass in her stool, but they will likely cause a lot of scraping and scratching inside. A daily probiotic supplement was suggested for the next couple of days, at least, to help her gut heal. We will also be evaluating Zuni again in the near future to determine if the heart murmur has resolved or requires a further work up.

Dogs eat a ton of stuff that really isn't very good for them, and usually they emerge from the experience relatively unscathed. In the kitchen, care should be taken to keep chocolate, grapes and raisins, macadamia nuts, onions and garlic, moldy food, uncooked potatoes, bread dough and xylitol artificial sweeteners (found in chewing gum, for example) way out of their reach! If your pet does eat any of these things, call your veterinarian for advice. The dietary indiscretion might turn out to be no big deal, but a simple phone call could save your pet's life.