You have just gotten off a long day of work and driven home on Feb 14th. You arrive home to your love one that has a glass of wine ready when you walk through the door.  You are escorted to the bedroom where there are rose petals and chocolate adorned across the bed, and also Fluffy (all names changed to protect the accused) eating said chocolates.  This was the story I had from a lovely couple presenting to me in an exam room several years back on Valentine’s day.  They, like many people, understood that chocolate is toxic to our companion animals.  Dogs are the typical choco-burglar, but chocolate can cause toxic signs to cats, they just typically don’t get into as much trouble as their dog brethren. That couple, who showed romance is still alive and well, brought Fluffy in to protect against the clinical concerns associated with chocolate toxicosis.

Concerns of Chocolate

When we talk about the ingestion of chocolate, as a veterinarian, there are three major concerns: 1) the Methylxanthine levels, 2) the fats and sugars and  3) mechanical obstruction from wrappers.

1. The Methylxanthine Levels

We are going to nerd out here for a second, but stick with me.  Methylxanthines are substances  found in foodstuffs. In the case of chocolate, we are talking about caffeine and theobromine.  These compounds work on the system causing an increase in catecholamine (like dopamine and adrenaline) synthesis and release.  The increase of those hormones lead to an increase in stomach secretions, increase in heart contraction, and stimulation of the central nervous systems.  The manifestation of those changes include vomiting and diarrhea, first and foremost. As the dose of caffeine and theobromine increase then we will see agitation, inability to settle and lay down with further progression leading to tachycardia (elevated heart rate) and arrhythmia (irregular heart beat) to more serious concerns of tremors, seizures and coma, and very rarely death.

Caffeine is fairly quick acting on the system, with clinical signs coming on in the first hour after ingestion. Theobromine can take longer, sometimes >2hrs, but theobromine can stay in the system for 3-4 days.  Each type of chocolate has different levels of caffeine and theobromine in them based upon the amount of cacao in them.  So, chocolates that have higher levels of cacao are more toxic:  White chocolate has a negligible amount of these substances, thus ending the age old question: White chocolate is not a chocolate, sorry.  Dark chocolate has a higher amount of cacao than milk chocolate. The increase in cocoa leads to an increase in toxicosis, leading semisweet to be worse than dark, baker worse than semisweet and then cocoa powder being the most concerning.  Straight cacao beans are the worst of course, but hopefully, not many people have them in their homes, and if they do, the bitter taste would be a deterrent, but there are always labradors.

2) The fats and sugars

If you ever taste dog food or milk bones (which I am not advocating for) you will note they are bland and dry.  Dogs diets are far less exciting than our diets.  So when our four legged love ones choose to partake in chocolate and chocolate based treats (cake, brownies, cookies, ice cream, etc) their gastrointestinal (GI) system is not able to handle the increase in fats and sugars.  This leads to GI upset manifesting in vomiting (sometimes dark colored chocolate smelling liquid), diarrhea, painful abdomen, not eating, and lethargy.  In more severe circumstances, it can even cause a severe metabolic disease called Pancreatitis, which is inflammation to the pancreas.  This can develop within hours of ingestion or days and may need completely different care than what we provide for the toxin nature of chocolate.  The concerns we have in this circumstance have nothing to do with toxins, it has to do with the rich nature of these treats.

3) Mechanical Obstruction from wrappers or coverings

The last concern we have is the undigestible portion of what was consumed, whether it was the wrapper of the candy bar or the covering over the cake.  I have yet to meet the discerning pup that takes the candy bar out of the wrapper to consume it, more often, when I make these pups vomit, they vomit the candy bar in its wrapper unchanged.  These materials that are not able to be process and digested by the stomach may cause an obstruction in the stomach or lower down in the intestines.

Taking care of them: What do we do?!!

Ok, so we know all the scary things that can come about from chocolate ingestion, what do we do about it? The first thing is to intervene as soon as possible.  If we are able to decontaminate before clinical signs then the prognosis is better, and just as important it tends to be more cost efficient.  The first line of defense is making the confectionary criminal of chocolate, vomit.  The most common tool we have is a medication called Apomorphine, but there are other options such as a drug called Clevor.  The goal is to make them vomit until they are producing very little to no further material.  While we are making them vomit, we will also be asking you some very important questions: What type of chocolate? How much? How long ago?  This allows us to understand the level of concern and to provide the best next recommendations.  And to answer the most common question during this time; No, your pup will not learn from this, and when given a chance will do this again.   Once we feel we have adequately emptied your pup’s stomach, we give them an anti-nausea medication to settle the stomach, 1) because we are not meanies and 2) we plan to give them a compound called activated charcoal.   Activated charcoal is an oral thick liquid that binds to the contents in the GI system decreasing the absorption.  Depending on how quickly we intervene and clinical signs, sometimes that is all that is needed, and we get the Snickers stealer back home to you.

In more severe cases, especially if the heart rate is increased or we see tremors, we would recommend hospitalization with IV fluids to flush the system of the toxins faster.  We may give medications that will lower the heart rate or relax muscles to stop the tremors.  In severe cases we place a urinary catheter as the toxins (those pesky methylxanthines) are excreted from the kidneys and can be reabsorbed while in the bladder.  And remember, Theobromine can stay in the body for 3-4 days, so care may take a couple days.

Some other considerations to have, especially when taking your pup home, is to slowly reintroduce food and water.  We have just made your pup vomit and so they may still be nauseated.  We usually recommend waiting a little bit before introducing food and water again.  Once they are allowed to eat and drink again, it is recommended to only offer small amounts, especially water.  It is common for your dog to want to drink large amounts of water, but it is best to give smaller amounts and then give an hour or two to digest, and then provide another small amount until the drive to drink is not as significant.

Other resources

We are very lucky in our profession, mainly because our animals make a lot of bad decisions, that we have organizations that have vast databases of different toxins and their effects.  As a field, we lean on these organizations to help direct prognosis and care.  The most long standing one is called ASPCA Animal Poison Control Center 888-426-2235 and the other most common is Pet Poison Helpline 855-764-7661.  These organizations can be contacted about chocolate and other toxins if you are concerned, to inform you if you need to seek veterinary care.  There is a cost associated with contacting these organizations, and they will ask for the toxin, the amount of toxin, how long ago it was ingested, weight of your pet, and if there are any current clinical signs noted when calling.

Having the pleasure of being in this field as long as I have, I have made many Rolo robbers vomit.  Valentine’s day is a common time but don’t forget about the ghost and ghouls around Halloween, that sneaky Easter bunny, or the absent minded Santa (he gets distracted with those cookies) providing opportunities for the pups to get into some trouble. If at any time you ever have questions, or your pups and cats needs care, please feel free to lean on us to walk you through those hard moments, that is what we are here for!