LEAD TOXICOSIS

About the Diagnosis

Cause: Lead is a heavy metal. If it is inhaled or ingested (eaten, swallowed), it can cause serious medical problems for dogs and cats, a health problem referred to as lead toxicity. Younger puppies and kittens are generally diagnosed with lead toxicity more often than older dogs and cats, perhaps because they are more likely to chew on things they should not. Sources of lead include lead-based paint (including dry paint on wood, walls, and other surfaces), batteries, golf balls, roofing materials, lead pipes, leaded gasoline and oil from leaded gasoline, lead pellets and shot, rug padding, linoleum, improperly glazed ceramic food or water bowls, curtain weights, and fishing sinkers. Symptoms of lead poisoning are generally gastrointestinal (digestive), such as vomiting and diarrhea, and neurologic, such as confusion or even seizures (convulsions).

Lead can cross the placenta of a pregnant dog or cat and affect her fetuses. Lead can also be excreted in milk during nursing.

Diagnosis: Your veterinarian will perform a physical examination to look for symptoms of other illnesses that could be mistaken for lead toxicity. It is essential that the pet's complete medical history be shared with the veterinarian because information that seems insignificant on the surface might hold important clues concerning exposure to lead.

A complete blood count (CBC) is a blood tests that may be performed to identify abnormalities characteristic of lead poisoning (e.g., anemia and nucleated red blood cells). Serum biochemistry tests are additional blood tests that provide information about the pet's kidney and liver function and overall health status. X-rays of the chest and abdomen may be taken to identify lead in the gastrointestinal tract. To confirm a diagnosis of lead toxicity, your veterinarian will send a blood sample to a laboratory where the lead level can be measured.

Living with the Diagnosis

When the diagnosis of lead toxicity is made, it is important to remove all lead-containing items from the household to prevent re-exposure or intoxication of other pets. If you suspect or know that your pet had ingested lead, contact your veterinarian immediately.

Keep pets away from areas undergoing building renovation that may have been painted before 1977. Much of the paint manufactured before this year contained lead. For this same reason, puppies that are "teething" (chewing objects indiscriminately) should not be allowed to chew on painted surfaces (moldings, lumber, furniture, etc.) since the paint covering them may be lead-based. Clean up roofing materials on the ground outside if there is potential for ingestion and do not allow your pet to lick or chew lead pipes.

Treatment

Treatment of a dog or cat with lead intoxication may first involve removing the lead from the gastrointestinal tract by inducing vomiting (emesis), flushing out the stomach (gastric lavage), and/or giving enemas. Large lead-containing objects occasionally need to be physically removed, either with an endoscope (minimally invasive), or if very large or awkwardly-shaped, with surgery. When lead has been absorbed into the body (long-standing exposure or ingestion not dealt with promptly), medication may need to be given to bind the lead in the blood, facilitating its elimination from the body through the kidneys and out of the body via the urine. These medications are known as chelating agents. Depending on the health status of your pet and the medication administered, treatment may take several days; a second course of treatment may be required. Your veterinarian may also give intravenous (IV) fluids to ensure that the dog or cat is well-hydrated, thus reducing the risk of kidney damage.

If necessary, anticonvulsant medication can be administered to help control seizures.

DOs

- Inform your veterinarian if your pet has ever been diagnosed with a medical condition or is taking medication; if possible bring the medicine container to the veterinary clinic.

- Give medication exactly as directed by your veterinarian, and if you are concerned about possible negative effects, discuss them with your veterinarian immediately, rather than simply discontinuing the treatment.

- Evaluate your home for items that (may) contain lead and do not allow your dog or cat to have access to them.

- "Puppy-proofing" and "kitten-proofing" the home can be lifesaving precautions and should be performed prior to bringing a new pet home.

DON'Ts

- Do not allow your dog or cat to chew or lick any object that you suspect or know contains lead.

- Do not assume that ingested lead will be eliminated in stools (feces) when your pet has a bowel movement; lead can dissolve during digestion and be absorbed into the body (producing its damaging effects) long before it is passed in the stool.

- If you cannot keep a scheduled appointment.

- If you are unable to give medication as directed.

- If you know or suspect that your dog or cat has ingested a lead-containing object.

- If symptoms do not improve after giving medication and especially if they worsen.

- If you believe that your dog or cat is having a negative reaction to medication (hives, excess drooling, anxiety, vomiting, diarrhea, respiratory difficulty, seizures, etc.).

Signs to Watch For

- General signs of illness: loss of appetite, weakness, lethargy, weight loss, abnormal behavior (especially hiding more than usual, unprovoked aggression, and disorientation).

- Signs of gastrointestinal (digestive) problems: abdominal pain, vomiting, decreased appetite.

- Signs of neurologic problems: blindness, muscle tremors, seizures, awkward or uncoordinated gait (ataxia).

Routine Follow-Up

- At least one and usually several follow-up visits can be necessary, to monitor symptoms and blood lead levels.