Toothpaste toxicity in pets

substance: Fluoride

categories:

Personal care

symptoms:

Abdominal pain / Arrhythmia / Bradycardia / Diarrhea / Hypersalivation / Vomiting

# Description

Fluoride is commonly found in products like toothpaste, mouthwash, and some water treatments. While fluoride is safe for humans in small amounts, it can be toxic to animals if ingested in large quantities. Pets who consume fluoride-containing products may experience symptoms like drooling, vomiting, abdominal pain, and diarrhea. In severe cases, fluoride poisoning can lead to arrhytmias and respiratory paralysis. Dogs are particularly susceptible due to their tendency to chew on various items. Toothpaste may contain xylitol (check xylitol section for its toxicity).

# Toxicity

all

Safe 0-0.6 g/kg
Mild toxicity 0.6-3.3 g/kg
High toxicity 3.3< g/kg

# How it works

When fluoride salts are ingested, they react with stomach acid to form corrosive hydrofluoric acid. Once absorbed, hydrofluoric acid disrupts calcium metabolism, causing hypocalcemia, and interferes with Na/K ATPase, leading to hyperkalemia. In severe cases, these electrolyte imbalances can cause ECG changes and cardiac arrhythmias. Hypocalcemia-induced respiratory paralysis and hyperkalemia-related cardiac arrest are the primary causes of death.

# Symptoms

Gastrointestinal: GI irritation, nausea, vomiting, abdominal pain, hemorrhagic gastroenteritis (HGE), oral irritation, and possible tooth enamel changes in young animals.
Cardiovascular: Cardiac arrhythmias due to severe hyperkalemia and hypocalcemia.
Metabolic: Hypocalcemia and hyperkalemia.
Hepatobiliary: Elevated liver enzymes.
Respiratory: Coughing, respiratory irritation, and muscle paralysis in severe cases.
Musculoskeletal: Painful muscle spasms, weakness, and skeletal fluorosis with chronic exposure.
Neurological: Hyperactive reflexes, tremors.

# Treatment

Emesis should only be induced with large recent consumption if the patient is asymptomatic. Usually, emesis is spontaneous, and induction is not needed.

Activated charcoal is not recommended due to poor binding with fluoride.

Use antiemetics and gastrointestinal protectants (such as IPP and sucralfate) as needed for gastrointestinal symptoms.

Fluid therapy is crucial to maintain electrolyte balance.

# Prognosis

If your pet ingests toothpaste, it’s crucial to assess the situation, contact a veterinarian, and monitor for symptoms. Prompt veterinary care can help manage potential toxicity effectively.

Symptoms

Poisons