— By Dr. Perry Jameson
Over the past month, I (Perry Jameson) have had three dogs come to the clinic with the same problem. They all lived on the Isle of Palms. They were young dogs, from 6 months to 2 years of age, well taken care of, up to date on vaccines and on heartworm prevention.
They had all been fed good dog foods and were well exercised. They were truly part of the family, living indoors and sleeping on the human children’s beds.
One day they were active, playful dogs, eating anything in sight. The next day they were suddenly lethargic, vomiting and not even interested when the kids dropped food from their plates.
Each one was brought into the emergency services overnight for these sudden changes. Blood testing would reveal that their livers had been injured.
The liver is an important organ that neither we nor our pets can live without. It has so many functions.
The food digestion and many of the things dogs eat are not safe for the body when first absorbed into the blood stream. This is why the majority of this stuff goes directly from the intestines up the portal vein and straight to the liver. The liver removes the unsafe chemicals and alters some of the others before releasing the blood to the rest of the body.
Most of these chemicals are put into the gall bladder so they exit the body out the intestines. The liver also produces bile which is stored in the gall bladder. Bile aids in the digestion of fats.
Proteins do not just go from the food eaten into the blood in the same form. The liver changes them into the forms needed. Albumin is made by the liver and is important for preventing the water portion of blood from leaking into tissues. The liver produces clotting proteins that, along with platelets, form clots to stop bleeding.
A dog's red blood cells will normally live around 100 days. They wear out and the old ones are removed and the bone marrow makes new ones to replace them so that levels remain constant. Parts of the old cells are recycled to make these new ones. The remainder of these old cells are removed by the liver and eliminated from the body as bilirubin.
So if the liver is injured, toxins that the liver filters from the blood will build up, which is why the dogs were nauseous, had no appetite and were lethargic.
Of the three dogs, two had elevated bilirubin levels causing their skin and gums to appear yellow, which is called jaundice. One dog was anemic and appeared to have digested blood in her stool, most likely from spontaneous bleeding as her liver was no longer producing clotting factors. This same dog had a puffy face and legs as a result of the swelling associated with the liver not making enough albumin.
With what appeared to be acute liver injury in young dogs, I usually suspect infections of, or toxic injury, to the liver. When I questioned each family about exposure to any toxins, two families had sago palms in their yards.
Sago palms are the smaller palms commonly used for landscaping in the Lowcountry because they prefer naturally dry, sandy soils of tropical and subtropical areas. All parts of the plants are toxic; however the seeds from the female plant are the most toxic component.
Toxicity can develop when dogs chew on any part of the plant. Ingestion of as little as one seed has been associated with death. No documented cases of sago palm toxicosis in cats have been reported, but until proven otherwise, I would anticipate the toxic effects to be the same as in the dog.
Onset of clinical signs may happen shortly after exposure or not show up for three days. Vomiting and diarrhea (with or without blood) are the most common initial symptoms, followed by lethargy and anorexia. Jaundice, spontaneous bleeding and other evidence of liver failure tend to develop later.
There is no definitive test for sago palm poisoning. We make the diagnosis based on compatible clinical signs as well as blood work changes and a history of exposure to the plant.
If a dog is observed eating part of a sago palm plant, the best thing is to have a veterinarian perform steps to prevent absorption. This may include inducing vomiting and administering activated charcoal.
Once liver injury has occurred, the only therapy is supportive to allow the liver time to heal itself. This usually requires hospitalization for several days to keep the dog hydrated, control vomiting and treat for bleeding. In some patients, some form of feeding tubes may be required.
As for my three recent patients, I was able to save only one of them. One pet owner commented that the cold spell had killed many of the sago palms in yards near his, and as pieces broke off or the dead leaves were trimmed off of the plants, they had blown into his yard.
As for most problems, prevention is the best therapy. If you have dogs, I recommend not having sago palms.
Dr. Henri Bianucci and Dr. Perry Jameson are with Veterinary Specialty Care LLC. Send questions to petdocs@postandcourier.com.
