I have written articles for the Times in various parts of the world but few more beautiful than where I am now, off the west coast of Sardinia.  A close friend asked me to join him on his sailing boat for 10 days or so. Although I have never set foot in one before, I jumped at the chance despite a little trepidation.  All those ropes (lines) and pulleys to trap fingers let alone the possibility of feeling seasick the whole time.  I needn’t have worried though. My captain knew I was ignorant of anything nautical so I could concentrate on my role as cabin-boy!  As for feeling nauseous, that wasn’t a problem either. The same cannot be said for the constant stream of vomiting dogs we’ve seen at the clinic recently. The main reason? Ingesting (eating) non-food items.

We all know dogs eat stuff, some of which are clearly non-food items.  What induces a dog to chew a battery, toy dinosaur, or eat non-food items like an inhaler is beyond me. These three items represent different dangers when ingested but all of them are potentially serious. Alkaline batteries are probably the commonest in our homes. How many of us are diligent at recycling them immediately they run down? 

If chewed and ingested by your happy hound, the chemicals inside are caustic and toxic. They cause chemical burns to delicate tissues in the mouth and oesophagus.  The heavy metals inside the casing can also cause toxicity if the battery sits in the stomach for a few days.  Button-type batteries are even more hazardous as once in the gastro-intestinal tract, an electric current between the two sides of the “coin” damages the surface on which the battery rests, resulting in ulceration of the stomach or intestine.  A 3v Li-Ion button battery can burn all the way through in just 30 mins!  

Electric currents and toxic metals aside, ingesting non-food items such as batteries can cause further problems, such as obstructions, like any other foreign body (eg children’s toys).  The question we as vets have to ask is whether the nausea and vomiting the patient is suffering is due to irritation, inflammation or obstruction.  Also in the mix are medical conditions of the pancreas, the liver, the kidneys or anything else in the abdomen, thorax or nervous system. 

So just about everything! That’s why we almost always perform blood tests first and then use imaging with x-rays and ultrasound if necessary.  Even with these modern diagnostics, ultimately if we are still in doubt an exploratory operation is called for to check the abdomen for abnormalities and take biopsies if necessary.  It’s not an unreasonable question to ask, with all the medical paraphernalia we have, why is there still uncertainty? Well, partly it’s due to some foreign bodies being invisible on x-rays (in fact, many of them are) and abnormalities on blood tests can be incidental findings that have nothing to do with the presenting problem.

I have encountered many different causes of intestinal obstruction, from stones and bones to chains and stockings.  Anything long and elastic is by far the worst. The intestine constricts around the length of the material which then cheese-wires through it, resulting in peritonitis.  As there are multiple sites of damage, repair is very difficult and the infection can be impossible to contain.  So, lock away the underwear and secure the lid on the dirty linen basket – a special target for some dogs.

The rise in childhood and adult asthma means many households have inhalers scattered around the place. The active ingredient inside is often a bronchodilator (salbutamol also known as albuterol) that stimulates the receptors in the lungs to open up small airways through muscular relaxation. However, the dose for a human user is carefully metered, delivering a very specific amount per puff. Not so when the quite-definitely-non-asthmatic dog is chewing it (cats can get asthma but dogs do not).  As the inhaler canister is under pressure, one puncture by a tooth releases the entire contents immediately. This results in an almost certain overdose.  Symptoms include a racing heart and breathing rate, restlessness, tremors, collapse, vomiting, low blood potassium and glucose and in extreme cases, even death.

If this happens in your home, contact your vet immediately. Bring the remains of the inhaler, any packaging and also details of any medication your pet may be taking.

Dogs suffering from this toxicity will need hospitalisation for 12-48 hrs during which intensive fluid therapy is necessary to correct electrolyte and glucose levels.  Heart rate will need to be slowed by giving beta-blockers (salbutamol is a beta receptor stimulant). Close monitoring of blood pressure is necessary.  With prompt and effective treatment, inhaler toxicity is rarely fatal although patients with pre-existing heart conditions or those on medications that react adversely with the salbutamol are at increased risk of complications.  Be aware that empty inhaler canisters still contain enough to cause toxicity in a small dog or puppy. Dispose of them promptly and safely, along with your alkaline batteries!

As the yacht on which I am sitting gently rubs up alongside the multimillion-pound luxury motor launch (much to that crew’s distain), the fish literally swarm around us in the harbour, as they have done all around the coast of this wonderful island.  My first taste of being under sail has been eye and mind-opening. I think I’m beginning to understand our Nation’s maritime obsession. Alas, we will probably never quite understand the delights that our pets find in ingesting non-food-related items.