Medicine Section

CHOCOLATE

1. What is toxic?
• Chocolate contains two types of methylxanthine, theobromine and caffeine, with their amounts varying depending on the type of chocolate.
• Methylxanthine content in
• milk chocolate - 60 mg/oz
• dark chocolate - 150 mg/oz, and
• baking chocolate - 450 mg/oz
2. What happens?
• GI upset - vomiting and diarrhea can occur with any amount because of chocolate's high fat and sugar content.
• cardiovascular effects (e.g. tachycardia, hypertension or hypotension, arrhythmias)
• CNS signs (e.g. agitation, pacing, hyperactivity, tremors, seizures).
• How much is toxic and how?
• The toxicity depends on
• type of chocolate
• the amount ingested,
• the size of the animal, and
• the animal's sensitivity to methylxanthines.
• Ingestion of around 20 mg/kg methylxanthine causes mild stimulation such as hyperactivity, agitation, and restlessness.
• Ingestion of around 40 mg/kg methylxanthine leads to cardiotoxicosis and
• Ingesting more than 60 mg/kg causes severe CNS signs, such as tremors and seizures.
3. How will you treat?
• Induce emesis or perform gastric lavage, use activated charcoal
• Monitor the patient's vital signs
• If cardiotoxicosis suspected - Continuous electrocardiogram (ECG)
• Perform baseline serum chemistry profiles
• Monitor electrolytes
• With intravenous fluids methylxanthine excretion is expected.
• If tachycardia-beta-blockers (e.g. propranolol, metoprolol)
• If nervous signs -diazepam
• To avoid reabsorption of methylxanthines from urinary bladder avoid urine in bladder preferably catheterize and remove urine catheter to keep the bladder empty.