Hidden Dangers in Your Kitchen: Uncovering Allium Toxicity in Cats and Dogs
Do you love cooking with onion and garlic? Although these ingredients are delicious in human food, they should not be consumed by pets. Allium, which includes garlic, onion, and chives, can be toxic to pets in raw or cooked form. In this episode, we discuss which animals are most affected by allium toxicity and what pet owners should consider when purchasing food or treats that may contain allium. We will also dive into the importance of thinking about the breed of dog you have and any medications they may be taking, as some breeds and medications can mix negatively with allium.
Listen in as we explore how allium toxicity damages the body of your pet and the clinical signs that show your pet has been affected. It's crucial to be honest and thoughtful when answering questions from your veterinarian about your pet's exposure to allium. If your pet has ingested allium, I will explain what your vet will do at the hospital to help your pet. Remember, time is of the essence, so it's essential to act quickly if you suspect your pet has been exposed to allium.
What You’ll Learn:
What happens to the body if garlic, onion, or chives have been consumed.
What part of these plants is toxic to pets.
Which animals are most affected by allium toxicity.
What breeds are more susceptible to the toxin.
Signs that show your pet may have eaten garlic, onion, or chives.
The importance of answering all of your vet’s questions honestly.
Why you shouldn’t try and make your cat vomit at home.
What your vet will do at the hospital to help your pet if they have eaten a toxin.
Ideas Worth Sharing:
“Allium toxicity can cause something called anemia and anemia means that we have a lack of red blood cells or not enough red blood cells.” - Tyler Sugerman
“Remember that although you know what is going on at your house, your vet doesn't. So it is important that you answer every question honestly and thoughtfully.” - Tyler Sugerman
“If you have a cat and you need to make them vomit, just bring them into your veterinary hospital. Don’t try to do this at home. It is very hard to make them vomit.” - Tyler Sugerman
Resources Mentioned:
ASPCA 888-426-4435 or pet poison helpline 855-764-7661
Read The Transcript:
Welcome to Vetsplanation. I'm your veterinary host, Tyler, or you can call me Suggs. This podcast is about educating pet parents about what is going on with their furry little loved ones. As an emergency veterinarian, I understand how hard it is to explain complex diseases in terms that are understandable for pet parents in a few short minutes before the next critical case comes in.
In this podcast, we can dive deeper into understanding of what our pets are going through and break down those complex medical terms into easier to understand chunks of information.
Just a quick disclaimer: this podcast is for informational purposes only. This is not meant to be a diagnosis of your pet. If you have questions about diagnostics or treatment options, please talk to your veterinarian about those things.
Remember, we are all practicing veterinary medicine, and medicine is not an exact science. Your veterinarian may have different treatment options. The information I provide here is to help pet parents, and it's not related to my place of work. I'm here for you guys to provide free information and knowledge.
If you like our podcast, consider sharing this podcast with at least one friend or someone else who has pets and could benefit from this.
Now, let's jump into this week's episode.
Tyler Sugerman: Hey guys, welcome back to the podcast. So, I'm doing this during the day again, so I'm sorry if you hear my dogs barking. Definitely, my little dog Holla is hanging out here with me, so you'll probably hear her snoring as well.
But today, we're going to talk about garlic and onion toxicity. So, I am going to just put this out here real quick. I am here just to talk about the toxicity portion of it, not to talk about whether it should or should not be used for certain purposes, but we'll talk about a little bit about what those other purposes are in a bit.
So, garlic and onions, there's actually like a bigger group of them. We think about just garlic and onions, but it's actually the allium group or allium species that we get worried about. And that's usually garlic, onions, chives and leeks fall into that group. And this is toxic in the raw form, the cooked form, dehydrated flakes, granulated forms, and even the dry onion soup mixes, all of those can potentially be toxic.
So, the part of the allium that causes the toxicity, it's not 100% known, like they are pretty sure that they know that this is what it is, but they believe it's to be a sulfur. So, this is just a different type of compound that's in it.
But they think that what happens is that when we chew or we chop up the onion or garlic or during the cooking process, it breaks down the plant, and then it releases this product that's bad for us or bad for the dogs and cats.
And then to further that, the dog or cat eats it and then their GI or their intestinal microbes or bacteria that are normally in their body and should be there, will break down that material even more, and makes it absorb into our bloodstream. And then when it’s absorbed into the bloodstream, it does all the havoc on the red blood cells.
So, I'm just going to describe real quick what the red blood cells do, and then eventually, get into how it's affected.
So, red blood cells, their job is to hold oxygen and move oxygen from the lungs to other places. So, like lungs to your brain, to your heart, to your pinky toe, so it supplies the oxygen to everywhere in the body.
And what our onion and garlic toxicity do, it makes it to where it cannot hold that oxygen anymore. So, it doesn't matter how many red blood cells you had, your red blood cells cannot hold enough oxygen to be able to bring to the rest of your body. Again, I'll get into a little more detail on that later. I just want to have a bit of a basic understanding of that.
So, who is affected by this? We have both dogs and cats are more affected by it, but cats are more sensitive than dogs are. For some reason, their hemoglobin, which is like this little particle or protein inside your red blood cell that holds oxygen, it's a lot more sensitive to damage than dogs’ hemoglobin is.
Just a random fact, it also does affect livestock as well. Like it can affect cattle and pigs, goats and sheep. But oddly, they can actually develop more of a tolerance for this over time when they're being fed small amounts of that just consistently in their diet.
So, let's talk about the amounts that cause toxicity. So, in small amounts, this is actually okay. They've been putting it in things like dog treats, in some dog foods, and people have used it as a home remedy for flea control. So again, I'm not going to talk about whether you should use this for flea control or should not use this for flea control.
What I can tell you is based on the literature, there's not been a lot of research put out there like true peer-reviewed research that has said that it works for flea control, but it has been found in humans, in human literature, medicine, that they've used it as a mosquito repellent, and it has worked for that. But they said for fleas it did not work for humans.
So, there's a lot of talk about there about whether you can use garlic as a flea control and how effective it is versus in people who want to do a lot of home remedies, versus there's a lot of talk about how it doesn't work at all. So, again, that's not my department, that's not what I do, is flea control. I'm an emergency vet so I stick to what the toxins are going to be cause that's usually what I see them for.
So, like I said, small amounts are okay, small amounts are not going to be a huge deal in dogs specifically. In cats it's a little bit harder. In cats, the ASPCA actually says that it is unsafe to use in cats at all. So, they don't recommend giving it to cats in their diet at all or for them to eat it up after you're done with your plate and stuff. They say that any exposure is unsafe for cats.
For dogs, they say about five grams per kg of onion or five grams. So, basically like two and a half grams per pound essentially, can be safe for them. They have had a toxicity at that amount and so that's why the ASPCA recommends no more than five grams per kg or two and a half grams per pound.
Now, even with that, that's just where they found the toxicity. There have been other sites, other data that is suggested 15 to 30 grams per kg is okay, but I think there's a lot of things that go into this as to whether it really is okay or not.
So, some of the other things that we have to think about are the type of breed that dog is. So, some of the Japanese breeds, they have a problem with not being able to have this antioxidant property. So, antioxidants are there to get rid of what's called free radicals or think about these as like little unstable molecules.
So, our body is supposed to have antioxidant properties to get rid of these unstable molecules and some of these Japanese breeds just … it's a hereditable problem. They were just born with it, they can't get rid of these very well and so they can be more susceptible to those.
The other thing is whether that animal is taking certain medications, if they're taking a drug that already has sulfur in it or propofol can be another one.
So, if you have a dog that's on a diet that has garlic or we know that that dog got into a large amount of garlic or onions, then we want to avoid things like propofol, which is an anesthesia that we’ll commonly use. Large doses of vitamin K that can actually cause them to be more susceptible to having garlic or onion toxicity. And even things like acetaminophen.
So, Tylenol, if they take Tylenol, that's really important for us to know — if they've gotten into garlic or onions because again, it's going to make them more susceptible to that toxin. Let's talk more about what this toxin does.
So, like I said, it causes our red blood cells not to be able to hold oxygen correctly, and when that happens, it almost disfigures the red blood cell so that it's very easily able to be destroyed. So, the best way I can describe this is if you think about if you had a block of ice and your block of ice is not easy to just destroy.
If I said take this block of ice, smash it with your hand, one hit, are you going to be able to do it? Probably not, but in this situation, we're changing the way that red blood cell looks, and it almost makes it where if I was to like take that block of ice and flatten it to a very thin sheet of ice, could you break that? Absolutely, much easier to break down.
So, what our onion and garlic toxicity does is it changes the inside of that red blood cell and makes it so that it's no longer this really nice round shape. It actually has more of like to me, like it actually looks like a ghost is the best way I can describe it, when we're looking at these red blood cells, like the ghosts from Pac-Man.
So, it has this nice roundish top head and then it has a ruffle at the bottom, but they're supposed to be nice and round so that that way they're able to fit through these little, tiny places, like our little tiny veins and our little tiny arteries and we need them to be able to be easily manipulated which is what that nice round shape does. But then when we make it no longer round, it's very easy to break down.
So, that's pretty much what it does, is it causes something called an anemia. An anemia means that we have lack of red blood cells, not enough red blood cells. So, this particular type of anemia is called a Heinz body anemia because we form these weird little outcroppings on the red blood cell, that again, make it very easy to destroy.
The other thing that it can do is it can lead to something called methemoglobinemia, super long word. Really all that means is that it can actually make it to where we can't hold the oxygen well anymore.
Maybe we have all of those red blood cells in there but it's just not holding oxygen and sometimes, it'll make their gums turn a bluish or grayish color because they don't have that nice pink color that we have from our red blood cells. We don't have enough of them and of those red blood cells, they're not able to hold oxygen really well.
So, these changes to the red blood cells start occurring within about 24 hours after ingesting that garlic or that onion, or whatever it is from the allium family. It kind of peaks at about 72 hours for it changing all of these red blood cells and then starting to destroy them.
And after about three to five days or typically, within three to five days, homolysis occurs, which just means the destruction of red blood cells. We're starting to destroy all of them about three to five days afterwards.
This can still last for about a week afterwards, but that's the typical timeframe for it. It depends on how much they had gotten into, how susceptible they are, and like I said, there's so many factors to that. So, let's talk about what are our clinical science from all of this?
So, first, initially, you're not going to know besides if you gave them the garlic or the onion, or let's say you were cooking, and you just saw it was disappeared. First thing to do is just smell your dog's breath. Does it smell like garlic or onion? Because if that's the case, they probably got into the garlic or onion. After that though, like let's say it's the next day, there's just no way you're going to know.
Unfortunately, for us, we kind of have to know the history like knowing they got into this garlic or onions or anything from the allium family. Later on, after that hemolysis or destruction of the red blood cells occurs, later, you're going to start seeing things that are clinical signs of anemia, so of not having enough red blood cells.
So, later, you're going to see that they have really pale mucus membranes. So, if you look at their gums on their mouth, they're very pale, they look very white, they'll be tachypenic, which means that they are breathing really fast because they don't have enough oxygen because even though they're breathing really quickly, they still can't get enough oxygen into their red blood cells to take to other places.
They'll have a really high heart rate that's called tachycardia. The high heart rate is because they're trying to quickly move these red blood cells that have oxygen to all around the body. But that's kind of detrimental to them because the fact that the faster the heart works, the more oxygen that it needs, and we don't have enough oxygen to bring back to the heart.
And cause weakness and collapse and cause vomiting, not wanting to eat, icterus or jaundice as the other term for it in human medicine, but just meaning that their skin turns yellow. Typically, you'll see that their eyes turn yellow first, like the white part of their eyes will turn yellow, the inside of their ear will turn yellow, and then on their belly will turn yellow. Those are the most obvious places that you'll see it.
It could be that they have hemoglobinuria, so that means that their urine looks red, like it looks like there's blood in their urine. But when we take a sample and we spin it down, any red blood cells should fall to the bottom of that urine sample. But in this situation, it doesn't, it stays just red.
And that's another indication to us that there's something big going on that we have hemoglobin which is that little cell that holds the oxygen inside the red blood cell in the urine which shouldn't be there, the body should not be getting rid of that.
It could sometimes cause hypoglycemia which just means that they have low blood sugar. And then in other cases, like I had said before, your mucus membranes or their gums might turn a purple or a brownish color, and then unfortunately death is a possibility with these guys as well.
So, let's talk about how I as an ER vet can diagnose this. There is no test for me to diagnosis this, like there is no toxicology screen that I can send out and say, “Is this an onion or a garlic toxicity?” Unfortunately, the very first thing is listening to you and your history.
If I start asking you questions — and I know I had a client who got really upset about me asking questions the other day, but you have to remember, even though you know what's going on at your house, I don't know what's going on at your house. I don't know if there's a possibility of them being able to get into some of these toxins, and asking these questions over and over in different ways can sometimes help lead us to a different answer.
So, when I'm asking questions that my technicians have already asked you, it's for a specific reason. My technicians, yes, they told me there are no toxins that they could get into. But if I start asking you very specifically is there a way they could have gotten into Tylenol or acetaminophen, or gotten into a onion or a garlic, I'm going to ask you very specific questions for a reason.
We need to figure out what the cause of this is in the first place. So, for me, history is going to be the biggest component of this, asking you a thousand questions, trying to figure out what they could have potentially gotten into.
The second biggest thing is looking at their blood. So, we can take their blood and put it on a slide, and we stain it so that we can see different types of blood cells, and then we look at it under the microscope. This can be really difficult, red blood cells are small, and so it is hard to see some of these changes sometimes, and especially when there are tons of red blood cells in there.
So, sometimes, we have to send these out to the lab, so we send it to what's called a pathologist. They are people who look at blood smears or look at lots of other things, but that's one of the things they look at is looking at the blood to tell us if they see some of those things that we would see as changes indicating that there was a garlic or an onion toxicity.
So, sometimes sending those out because we're looking for tiny little bumps, we're looking for tiny changes in the red blood cells, and I had one the other day that we couldn't tell if it was a garlic or onion toxicity, or if it was a different type of problem, an autoimmune problem.
And after looking at it, there was like cells that looked like both of them. So, sometimes just looking at those or just sending it out to the lab can be super helpful for us. And then just remembering too that even if they see a lot of these things that we were looking for, for an onion or a garlic toxicity, there are still other differentials for these specific things that we're looking at in the blood.
It can be that they have a zinc toxicity. So, zinc is commonly found in pennies and so we'll take X-rays so we can check to see if there's any pennies in their system. There's weird moth balls that can cause this as well and even skunk spray that can cause this too.
We talked about acetaminophen can look a lot like this, so if they've gotten large doses of acetaminophen or Tylenol. So, we can't be 100% sure just by looking at the blood again like history from you guys is going to be the most important thing.
Now, what about the treatment of this? We've talked about all the things that it can do. Like how are we going to treat this?
Unfortunately, there is no direct treatment that I can give. So, there's not a pill that I can give to say, “Here you go, just take this pill three times a day and it's going to be gone out of the system,” it doesn't work like that. Unfortunately, the best situation is that you are home, you saw them eat the garlic or onions, and immediately, induced vomiting.
So, if you're within about a three-hour — they'll even say like up to six hours sometimes time period, then usually, just making them vomit. The best way to do that is to bring them in because we have specific drugs to help make them vomit.
If for some reason you have a dog and you are in a cabin in the woods four hours away, which I have absolutely had happen, you can give hydrogen peroxide, just make sure it's the 3%. And for dogs, the dose is 2.2 mills per kg or essentially one mill per pound, to a max of 45 mills.
Now, I don't always recommend giving hydrogen peroxide. I've definitely had people give it and then their dog aspirated, I've had dogs that have had burns from it. So, I usually recommend not to do that unless you absolutely have to, you have no other way to get them to a clinic.
Even if you can call poison control, so you can call the ASPCA, pet poison help hotline or you can call pet poison helpline either one of those and ask them if this was a toxic dose of garlic or onions because maybe you call and they're like, “You're probably fine.” I'd much rather you call, you do have to spend, I think it's like $69, $70, something like that.
But they'll tell you on the recording like how much it is, but you do have to call them and ask them like if this is a toxic amount. I'd much rather you do that than to give the hydrogen peroxide and create a much bigger problem that then they have to be hospitalized for because they got the hydrogen peroxide. So, call first if you can, give hydrogen peroxide if you absolutely cannot get to the clinic. But best-case scenario is you get to the clinic.
And this is only for dogs. In cats, I do not recommend giving hydrogen peroxide. One, your cat will probably try to kill you, like they do not want you to shove stuff down their throat, they hate it. Also, it doesn't work very well in cats. They could also cause other problems, so it is not recommended to do that in cats.
For cats, even when in the clinic, we have one drug, sometimes two that we can give and even then, it's not 100% that we'll get them to vomit, cats are so hard to make vomit. If you want them to vomit, they won't and if you don't want them to vomit, they will. I'll like put a carpet under them even just to try to help entice them to want to vomit on a carpet because that's what they always want to do.
They always want to vomit on the chairs or the carpets, at least my cat does. But anyways, if you have a cat, you need to make them vomit, just bring them in. Like there's really not going to be another option there, just bring them in.
And then activated charcoal is something that some people will suggest giving and some people will suggest not giving. It really kind of depends on the situation but this has to be like a very specific activated charcoal. I had a client who had given the coffee filter activated charcoal and (don't do that) that cat got really sick because they had given that charcoal which is not meant for being consumed and made that cat really neurological.
So, it was really wobbly, it had brain swelling, so we don't want to do that. We have a very specific activated charcoal that we give. But even then, they don't know if it 100% helps with the absorption or prevents the sulfides which are that chemical from them. They don't know if that helps stop it from being produced. So, I said some poison controls will say, “Yes, give it,” and some toxicologists at the poison control will say, “Don't give it,” and either way is appropriate.
Otherwise, let's say you did that or let's say maybe you know the dog got into it two days ago and now, you're just coming in because you're worried that they have symptoms from it because you didn't know that it was toxic. Some of the things you can do just to kind of monitor is going to be checking their PCB means that we're checking how much our percentage of how much red blood cells are in their body.
A normal should be between like 30 to 50%. Some people argue 35 to 50%, either way, that's a pretty close number and ideally, we're just checking to see if those numbers drop. So, if we start seeing those numbers dropping, that's not a good sign.
Your body should be producing more red blood cells on their own, which is exactly what dogs and cats do. They produce more red blood cells on their own to keep them at roughly that amount.
The other thing is to check blood smears daily. So, we're checking those red blood cells, we're looking at them under the microscope so we can see if there are changes daily to know if we're starting to have this Heinz body anemia or this lack of red blood cells due to how the red blood cell has changed.
If we start seeing some of those other signs, they're not breathing well, they are anemic, they do have really red urine, things like that, then hospitalization is going to be the best thing for them. We're doing a couple of things when they're hospitalized.
One, we're keeping them on oxygen, so we're giving them a large percentage of oxygen. If you think about the amount of oxygen that you are breathing right now, it's roughly 21% oxygen. When we put them into a cage, this tank essentially, or we put this nasal cannula into their nose and keep them on oxygen, we're giving them about 40 to 60% pure oxygen, and that helps to get more oxygen saturated into the red blood cells that we have that can hold those oxygen particles.
But even then, if we have so many red blood cells that are being destroyed or so many red blood cells that can't hold oxygen, we're trying to help them as much as we can, but we can't get more oxygen in them unless they have more red blood cells.
So, if they're really low in their red blood cells then we do blood transfusions. So, we're giving them back red blood cells, a high percentage of them so that hopefully, they'll be able to hold enough oxygen to help that dog or cat be able to breathe.
This can also be a little bit tricky as well because unfortunately, even though we're going to give them red blood cells, their body is still going to destroy those red blood cells. So, it is not uncommon that they need multiple blood transfusions in order to get them to the point where they're making more red blood cells on their own.
And then the other thing that we're going to do too, is give IV fluids. So, IV fluids are needed to try to help move the red blood cells around that we already have, but it also helps protect the kidneys because the kidneys are not supposed to have this hemoglobin going through them. That little particle that's holding the oxygen inside the red blood cell, it is not used to that going through those kidneys, and can eventually lead to kidney damage if that's the case.
We're also checking to see like do they need more blood sugar? So, we give them something called dextrose which is just an IV form of blood sugar essentially and doing any other medications that they may need.
Sometimes they're vomiting so we're giving medications to help stop vomiting. Sometimes they're having diarrhea, so we help give medications to help with the diarrhea, but we're just trying to help support them, and so the garlic and onion toxicity is out of their system, and they're able to make more red blood cells on their own.
I always warn people like this could be five days, it could be a week that they're in the hospital. It could mean multiple blood transfusions, like we just don't know.
Unfortunately, I even had two just in the last month and only one of them ended up making it. It's super sad, it's super sad for the clients, for you pet owners. It's super sad for us as the veterinarians and as the technicians. Like we put so much effort into all of our patients, and we want to be able to see them make it to the end and go home.
But unfortunately, that's not always the case, unfortunately, they don't end up being able to go home or unfortunately, they might get to the point where they end up being euthanized like the pet parent chooses to euthanize them because this is just more the humane thing to do or because we're going to need five more blood transfusions and that costs a lot of money to do that.
So, it is definitely okay like when we are at that point to where we know that it's not going to work, that it's okay to put them to sleep. But just know that we are always as the veterinary team always very sad and want to help them as much as we possibly can.
So, if we can help them, if everything goes well, like let's say in the very beginning if we were able to make them vomit right after they'd ingested the garlic and onions, they have a pretty good prognosis, they're going to go home and do just fine.
But when we get to the point of they need oxygen and they're not doing well, then unfortunately, like our prognosis becomes much more guarded, meaning that there's unfortunately more of a chance that they're going to not make it. Alright, so that's enough about our toxicity here.
This was kind of one that I wanted to do because I know we're getting into grilling season and lots of onions and garlic and stuff and grilling, I love grilling, so I know that there's going to be lots of it. But also, since I've just seen two cases in the last month, I just wanted to put this out there.
Like I said, there are people who use garlic and onions for other purposes, other medicinal purposes. Usually, I say if you're going to do that, I would suggest you talk to a veterinarian who does holistic medicine to determine the doses for that, and not just finding information online because we want to try to keep them as safe as possible.
Alright, let's talk about our animal fact real quick. So, our animal fact, I'm going to talk about seals and sea lions. I love seals and sea lions. I used to work with them, they're amazing. We're going to talk about something because I have actually gotten a couple questions from people about this. Like what is the difference between seals and sea lions?
So, some of the differences are — let's talk about the similarities first actually. So, they're both in the pinniped family along with walruses, and that just means in Latin, it's the fin footed species. So, sea lions are the ones that you usually see, like California sea lions are the most common ones that I think that I've seen.
They bark really loudly, they typically can walk on land because they have really big flippers, and they can rotate their back flippers forward as well to be able to walk. So, they actually do much better on land than seals.
They usually have visible ear flaps. So, if you look at some of them, you can see their little ear flaps. They're really social, so when you see them out on the piers and stuff on the buoys, it's because they like being in groups, they like to be around each other, like they're very social creatures.
And then they're also more comfortable on shores, like I said. So, they prefer to be on shore or on a buoy, or something rather than in the water versus seals.
Seals are going to be more like harbor seals, elephant seals, those are some of the more common ones that I've seen. But they have smaller flippers, so they can't really walk around easily on land. They tend to wriggle on their belly, so they don't really walk. Think of it as more like worm their way on the ground, but their rear flippers just can't rotate well. And also, their small flippers are so small that they just can't get themselves upright to be able to walk on land really well.
They usually don't have visible ear flaps. I will say there are some, like the fur seals, they have like little ear flaps, but in general, they usually don't have ear flaps. You usually have to be pretty close to be able to see their ears.
They're typically pretty quiet so they don't do a lot of barking. They do a lot of like really soft grunting noises instead, and they're very solitary creatures. So, you're actually not going to see them very often in groups. Like they're not the ones that you're going to see lined up on the piers and stuff, like they typically like to be in the water and be alone.
They're more formed for the water. They're usually more like a torpedo shape, whereas sea lions are actually not very good for like swimming. They have their flippers, but their body conformation is just not as good for swimming versus seals, their body confirmation is more like a torpedo and it's much better for swimming purposes.
Alright, as always, if you have any questions, please email me. I'm more than happy to talk about any topics that you want to learn about or if you have any questions about it. Alright, thank you guys.
Thanks for listening this week. If you have any questions, comments, suggestions, or you just want to say hi, feel free to email me at suggs@vetsplanationpodcast.com.
You can visit our website at vetsplanationpodcast.com, or you can find us on Facebook, Instagram, or TikTok at Vetsplanation.
Thank you all again for listening and we'll see you back here next week.