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Almost Short-Changed by Zinc Toxicity
January 2, 2012
We continue to be amazed at all the things we have seen over the years that dogs and cats decide to eat that they shouldn’t. Human medical professionals probably don’t often have to go in after swallowed tennis balls, strings, socks and underwear, rubber duckies, rocks, hair rollers or hambones that get stuck in their patients’ GI tracts. Needless to say, these cases always keep us on our feet.
Bauer, a 5-year-old Boston terrier with a peculiar taste for coins, is no exception. His story, however, turned out to be more than a foreign body. Bauer went to his family veterinarian at Loveland Veterinary Clinic after two days of lethargy and lack of appetite. Xrays of his abdomen revealed multiple coins in his stomach so his veterinarian induced vomiting. Bauer produced a total of three quarters, one dime, and four pennies. Xrays were repeated which showed one coin remaining in the stomach that appeared to be the size of a quarter. Because Bauer had become acutely ill, they decided to leave the quarter until Bauer was more stable. Bauer’s veterinarian did blood work which revealed anemia (low red blood cell count) and increased kidney values. The presence of the coins in Bauer’s stomach may have made him feel mildly ill, but they didn’t explain the blood abnormalities or the extent of his clinical signs.
It was the pennies that were suspected to be the cause of the blood abnormalities, lethargy and lack of appetite. Pennies minted since 1983 are composed of 96% zinc and coated with 2.5% copper. The zinc from the pennies was likely causing zinc toxicity in Bauer. Other zinc sources are certain types of nuts and bolts, galvanized pans, plumbing parts, staples, zippers, jewelry, and some zinc containing creams (ie; sunblock, Desitin, etc).
Zinc is a gastrointestinal irritant that can cause early symptoms of vomiting, diarrhea, inappetence and eventually severe dehydration. Symptoms will get progressively worse if not addressed. Zinc is gradually absorbed by the blood stream in the lining of the stomach. It can cause red blood cell destruction and changes in the way red blood cells look. It can also increase kidney values and liver enzymes severely to the point of possible multiple organ failure. Platelets are also affected which can cause a prolonged clotting profile and may eventually lead to systemic blood clot formation, utilization of clotting factors and then hemorrhage (a serious condition known as DIC).
The most common outward sign in zinc toxicity cases is pale mucous membranes caused by anemia. Other signs may include jaundice (yellowing of the skin) and decreased liver function. Gastric irritation may also cause vomiting, diarrhea and poor appetite. Bruising may be seen because of clotting problems. High respiratory and heart rates can also be noted. An increase in kidney values may occur because of severe dehydration and low blood perfusion to the kidneys resulting from anemia. Prognosis is guarded to poor. Zinc intoxication should be treated early and aggressively due to the severe complications that accompany this disease.
Throughout the course of the day, Bauer developed a high heart rate and respiratory rate and he was transferred to the Fort Collins Veterinary Emergency Hospital for continued overnight care for zinc toxicity. There he was given IV fluids, a blood transfusion, and oxygen. The following day Bauer was transferred to us at Peak Veterinary Specialists for continued care as well as an endoscopy of the stomach to remove the final coin. Dr. Lauren Prause elected to continue the aggressive treatment for zinc toxicity to assure that Bauer was able to undergo anesthesia for the endoscopic procedure. He did receive a second blood transfusion and within a few hours Bauer perked up significantly and Dr. Prause felt he was stable enough to perform the endoscopy. Dr. Prause was able to remove the final coin without any complications. By the end of the day Bauer was able to go home, free of the coins, his zinc toxicity being managed, and overall feeling much better. Peak did see Bauer for one more visit a couple days later to recheck the kidney values and anemia status. They were significantly improved and he is now completely recovered from the incident.
Bauer benefited greatly by the teamwork of all the staff and doctors at Loveland Veterinary Clinic, Fort Collins Veterinary Emergency, and Peak Veterinary Specialists.
