The Case of the Penny-Pinching Poodle
1. Referral:
“Ricky” is a ten-month-old male intact Toy Poodle* who presented for a three-day history of vomiting, lethargy, bright colored urine, and inappetence. He lives in an apartment and there is no known history of foreign body ingestion or tick exposure. On evaluation immediately prior to referral, he was noted to be laterally recumbent, have white mucous membranes, and have a grade II/VI holosystolic murmur. Based on the physical exam results, Ricky was referred to the ASG emergency service for further diagnostics and treatment.
2. Exam:
On physical examination, “Ricky” was recumbent, hypothermic, had white mucous membranes, and a grade II/VI heart murmur. No other significant findings were noted on physical examination.
3. Procedures:
We discussed IMHA, tick-borne disease, and toxicosis as differentials with the owners. An in-house CBC/Chemistry was performed, revealing severe anemia (HCT 8.7% ref range 37-55%), elevated BUN (50 mg/dL ref range 7-27 mg/dL), elevated alkaline phosphatase (664 mg/dL ref range 23-212 mg/dL), and hypokalemia (3.1 mmol/L ref range 3.5-5.8 mmol/L). PCV/TS was 11%/5.6. PT was within normal limits and aPTT was slightly elevated at 133 seconds (ref range 71-102 sec). Mean arterial pressure was 98 mmHg. Abdominal radiographs revealed a circular metallic opacity in the stomach.
4. Diagnosis:
Based on abdominal radiographs and blood work, zinc induced hemolytic anemia was suspected and Ricky was transferred to the internal medicine service for further treatment.
5. Treatment:
Ricky was given a one-half unit packed red blood cell transfusion and endoscopy was performed to remove a penny from his stomach. Anesthesia and recovery were uneventful. A recheck PCV/TS two hours post-transfusion was 24%/5.2.
6. Discussion:
According to a JAVMA article published in 2007, ingestion of zinc in dogs can lead to hemolytic anemia, acute renal failure, and pancreatitis. Pennies produced after 1982 contain both zinc and copper, and can therefore lead to zinc intoxication. Most common clinical signs noted were vomiting and pigmenturia. Zinc toxicity most commonly affects young, small breed dogs. Prognosis with treatment is good.
7. Recovery:
On discharge from the hospital two days after presentation, Ricky was bright, alert, had a great appetite, and was no longer vomiting.
by Emily Coddon, DVM,
Emergency + Critical Care
REFERENCE: Gurnee C M, Drobatz KJ. Zinc intoxication in dogs: 19 cases (1991-2003). J Am Vet Med Assoc 2007; 230: 1174-1179.
*Photo of Poodle is not “Ricky.”