Chocolate, chocolate and more chocolate!

From cakes to cookies to brownies and candy, it all looks appetizing to dogs. Some of these products do not come with labeling information that allows for exact calculation of methylxanthine quantity. Also don’t forget about hypernatremia in association with chocolate ingestions – it may not happen a lot, but if it happens to your patient you’ll take notice.

Methylxanthine calculations

We use some basic info in order to estimate methylxanthine dosages of ingestion. For cakes, we use 240mg caffeine per basic chocolate frosted cake (9 x 13 pan) and for an unfrosted basic chocolate cake 120mg caffeine/cake. (For both, we assume 12 pieces per cake.)

For chocolate-chip cookies, calculate the chips using 160 mg of caffeine and theobromine/oz. Even estimating how many teaspoons or tablespoons of chips are in each cookie can allow some rough calculations to be done. Brownies present the biggest challenge. We make the basic assumption that a 9 x 9 (or 8 x 8) inch baking pan contains 16 brownies and a 9 x 13 inch pan makes 24 brownies. Then we guesstimate the type of brownie. Other brownies and the levels they contain:

Marble brownies: In a recipe that uses 2 ounces of semisweet chocolate, for 16 brownies we’re looking at 20 mg per brownie.

Regular brownies: In a recipe that uses 4 ounces of Baker’s chocolate, for 16 brownies you can estimate 110 mg per brownie.

Intense brownies: In a recipe that uses 6 ounces of bittersweet chocolate, for 16 brownies estimate 170 mg each.

Ultimate brownies: In a recipe using 6 ounces of cocoa, for 24 brownies you can estimate 200 mg per brownie.

Gluten-free brownies: In a recipe using 4 ounces of cocoa plus 8 ounces of 73 percent chocolate, for 24 brownies you’re looking at 240 mg each.

Hypernatremia with chocolate ingestions

We do see hypernatremia pre-activated charcoal administration but after chocolate ingestion. Especially in dogs who are repeatedly vomiting, it’s important to check for hypernatremia before activated charcoal is given, as sometimes the sodium level will indicate foregoing activated charcoal. If charcoal is indicated, then rechecking a sodium level a few hours after charcoal is given can help hypernatremia be recognized before problems occur.

Kalanchoe

Kalanchoe spp is a succulent popular during the Christmas season because it produces bright flowers in the winter. Native to southern Africa, Madagascar and Australia, the plant has become naturalized in some areas of the southern United States but is most commonly found as a houseplant. While all parts of the plant are toxic, the flowers appear to be the most toxic part of the plant. Kalanchoe contains cardiac glycoside, bufadienolides, not that dissimilar from digitalis compounds. It inhibits the NA/K ATPase enzyme system. Potential clinical signs may include vomiting, diarrhea (potentially bloody), drooling, lethargy, tachycardia or bradycardia, arrhythmias, AV block, mydriasis, nystagmus, delirium, seizures, weakness and tetany. By far vomiting is the most common reported sign in our database, with lethargy, tachycardia, diarrhea and anorexia completing the top five reported signs. Onset of signs varies from a few minutes up to 8 hours. The course of toxicity is generally 12 to 24 hours, but there are reports in large animals of signs lasting up to five days.

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