By Alan Green and Sean Ellison

For all of us, understanding and being knowledgeable of the environment we live in allows us to enjoy the beauty while being respectful of the dangers. There is nothing more representative of this statement than the sago palm, a common and ubiquitous member of our surroundings in the Lowcountry. It is an honor this month to introduce Dr. Sean Ellison. Dr. Ellison is an important member of the CVRC Emergency and Critical Care team. He provides us important information about sago palm toxicity.

Although there are a myriad number of plants that, when ingested, create toxicity in dogs and cats, sago palms, also known as cycad palms or Cycas Revoluta, have a high probability of creating life-threatening clinical signs if early therapeutic intervention is not pursued. In tropical and subtropical climates where these plants are often planted in backyards where dogs and outdoor cats have easy access to them, a high potential for ingestion and subsequent toxicity exists.

Unfortunately, all parts of the plant are toxic though the highest concentration of the toxic principle, cycasin, is found in the seeds and roots, which can be the most readily available component of the plant for ingestion as they are easily accessed on and in the ground. Ingestion of as few as one to two seeds has resulted in fatal toxicity in dogs.

The initial clinical signs, occurring in as short a period of time as several hours after ingestion, consist primarily of gastroenteric signs (vomiting and diarrhea), abdominal pain and lethargy. Without rapid decontamination and therapeutic intervention, clinical signs will progress to depression, coma, liver disease and subsequent liver failure and death. Although clinical signs are usually observed within one day after ingestion, the onset of liver failure may be delayed up to three days after ingestion. Once clinical signs, especially liver disease, develop, the mortality rate is unfortunately high, with 32 percent of affected dogs and cats not surviving beyond several days.

Initial treatment consists of decontamination and it is this treatment step that is potentially the most important component of early therapy. Thus, the pet owner can never be over-vigilant in seeking veterinary attention for their dog or cat even if ingestion is simply suspected or if the type of plant ingested is not known. If recent ingestion is observed or suspected, it is imperative that the dog or cat be seen by a veterinary clinic immediately so that decontamination can be instituted. These steps consist of administering a medication to induce vomiting (with vomiting typically being effective to produce a high percentage of the stomach contents within three hours after ingestion) and subsequently administering activated charcoal, a medication that helps to bind the toxic principle of sago palms in the intestine before it is absorbed, thus decreasing the potential for toxicity. Following decontamination, hospitalization for ongoing therapies and monitoring is ideal. The length of therapies and monitoring is prolonged given that the time to onset of liver failure is delayed several days. Following hospitalization, intravenous fluid therapy will be commenced and medications to treat any vomiting that has emerged will be utilized. In addition, medications to support liver function and decrease the potential for ongoing absorption of the toxin will be started.

Since sago palm ingestion can create life-threatening toxicity, knowledge of the toxic potential of this plant is imperative to prevent dogs and cats from accessing areas where it is present. In addition, if ingestion of any components of this plant is suspected at any time, get in touch with your family veterinarian or a 24-hour veterinary emergency clinic to begin decontamination and monitoring.