FAB Chief Executive Claire Bessant travelled to Seville to speak to toxicologists interested in veterinary poisonings about how welfare organisations and veterinary poison centres can work together to raise awareness of poisoning problems. Claire's talk majored on the campaign FAB and the Veterinary Poisons Information Service (VPIS) ran in 2007 to highlight the dangers of using dog flea spot-on treatments on cats. 

The VPIS, represented by Alex Campbell, Nick Sutton and Karen Sturgeon also presented posters on various different poisonings in cats and dogs which had feline components, so we have summarised those of interest to cat owners.  The first reported on the success of the permethrin spot-on campaign.

The permethrin spot-on campaign
Permethrin is a pyrethroid insecticide commonly found in 'over-the-counter' canine flea treatments containing permethrin.  Although permethrin is of low toxicity to most mammals, it is highly toxic to cats.  The VPIS frequently receives reports of severe and fatal feline exposures. 

On the 1st August 2007 the VPIS published data in the Journal of Feline Medicine and Surgery stating that of 286 cases, 87.8% (251/286) of cats developed muscle twitching, tremors or convulsions, and that 10.5% (30/286) of cats died. 

The article gained significant coverage within the UK national media, as well as two consecutive front page headlines  in the weekly Veterinary Times. In the two months prior to publication the VPIS were referred 15 and 25 cases of feline permethrin exposure (June and July, respectively).  Within one month of publishing, 37 cases had been reported.  Prior to this the largest number of related calls in one calendar month was 25 (both October 2006 and July 2007).  Follow up data collected within one month of publication revealed that fatalities accounted for 21.4% (6/28) of cases.  Prior to this the largest number of deaths reported in one month was 3.

Graph to show the number of cases of feline permethrin poisoning reported to the VPIS between 2004 and 2007



The number of reported feline exposures to permethrin increased with publicity and veterinary awareness, confirming our suspicion that cases are underreported. 

Sutton NM, Bates N, Campbell A (2007) Clinical effects and outcome of feline permethrin spot-on poisonings reported to the Veterinary Poisons Information Service (VPIS), London. J Feline Med Surg. 2007 Aug;9(4):335-9.

Adder bites
Of 268 enquiries about adder bites in animals received in 2006-2007, 13 were in cats (the rest were dogs and one horse).  Follow-up data was obtained for two cats to which antivenom had been administered and they had recovered.  Some vets had commented on the difficulties of obtaining anti-venom and some were not able to obtain it for their patients (dog cases). Explanations were that local hospitals had limited supplies and/or were reluctant  or refused to provide it, because of concerns about stocks for human cases.  In some cases VPIS supplied the antivenom direct.

Onion, garlic  and chives – the allium species
Allium species (onions, garlic, chives) are known to cause oxidative damage to erythrocytes in dogs, resulting in haemolytic anaemia with Heinz body formation. Feline haemoglobin is potentially more susceptible to oxidative damage because of  its different structure and morphology.

This retrospective study reviewed cases of Allium species ingestion in both cats and dogs reported to the Veterinary Poisons Information Service (VPIS) to determine if Allium poisoning is more of a problem in cats than in dogs.
Basic details of every VPIS enquiry are recorded at the time of enquiry, with a follow-up questionnaire requesting further data on cases of particular interest. The returned questionnaires allow verification of data collected at the time of the initial enquiry, as well as further information on the course and outcome of the case from the treating veterinarian. These data are then collated and entered into the VPIS database.

16 cases of Allium species ingestion were reported in cats, only 4 had follow-up details available. One cat remained asymptomatic without treatment.

After ingestion of onions one cat had gastrointestinal signs, lethargy and polydipsia, but made a full recovery. Another died from haemorrhage into the pleural and abdominal cavities. Anaemia and jaundice were ongoing problems at the time of follow-up after a cat had eaten garlic cloves (Allium sativum).

These data show that the incidence of Allium speciescases reported in cats are comparatively low, probably because cats are  more fastidious about what they eat. However, these limited data indicate that feline cases are likely to be serious and follow a similar clinical course to those seen in dogs.

Treatment is recommended for ingestion of any amount of Allium species in all domestic animals. No specific antidote is available and therefore treatment should focus on limiting absorption, treating any effects of haemolytic anaemia and supportive care. A blood transfusion and oxygen may be required in those most severely affected .

Ibuprophen and paracetamol
Data was extracted from case reports regarding canine and feline exposures to ibuprofen and paracetamol between 1992 and 2007.  4625 cases concerning canine and feline exposure were identified and of these  249 concerned cats.   68% of feline cases concerned ingestion of paracetamol, while 32% involved ibuprofen. 

In dogs, multiple tablet ingestion is common. 81% of canine cases concerned the ingestion of more than one ibuprofen tablet, while 76% concerned the ingestion of more than one paracetamol tablet.  Only 9.3% of feline cases concerned ingested of large amounts (defined as more than 400mg)

Reports of dogs ingesting ibuprofen tablets are higher than those of exposure to paracetamol tablets.  Conversely, reports of cats ingesting paracetamol tablets are higher than those of exposure to ibuprofen tablets. This difference between reported canine and feline exposure may reflect an awareness of one tablet being more toxic than the other. In terms of mg/kg treatment does, ibuprofen is considerably more problematic to dogs, while paracetamol is more problematic in cats..  The severity of poisoning may also affect the frequency of case reporting. Calls concerning feline ingestion of paracetamol may be higher because the ingestion of as little as one tablet may cause serious effects.