Sago Palm Poisoning in Dogs

Sago palm poisoning is an emergency; if left untreated, it can cause the animal's death. The most dangerous phase of the toxicosis can be delayed up to 3 days from ingestion. Immediate medical attention is warranted as early treatment is the only way of ensuring the animal's survival.

Symptoms of sago palm poisoning can be classified according to the timing of onset.

Early gastrointestinal symptoms generally occur 24 hours from ingestion.

If the affected animal does not receive timely medical attention, the condition worsens, and acute hepatic failure develops 2 to 3 days from ingestion.

Sago plant poisoning is caused by the ingestion of all parts of cycad plants (leaves, seeds, "bark").

There are over a hundred plants belonging to the Cycas genus.

While the precise mechanism of toxicosis is currently unknown, plants belonging to the Cycadaceae family contain three different kinds of toxins:

• Cycasin: once ingested, cycasin is converted to its aglycone, methylazoxymethanol
• β-methylamino-L-alanine (BMAA), a neurotoxic amino acid
• A third unidentified toxin

If ingestion of a sago palm is witnessed, the diagnosis is self-evident. Although ingestion may occur without a witness, it can leave evidence, such as signs of chewing on the palm and traces of the plant in vomit. Currently, there is no definitive diagnostic test; animals presenting symptoms of sago palm poisoning generally undergo the following diagnostics:

• Vomit analysis: traces of chewed leaves, seeds, and other plant material may be present
• History of exposure
• Liver enzyme testing
• Complete blood count
• Serum panel
• Urine analysis

Once sago palm toxicosis is diagnosed, treatment depends on the condition's stage.

Treatment of subclinical cases is limited to prompt gastrointestinal decontamination. Note: Induction of vomiting or administration of activated charcoal should only be performed by a veterinarian. There is no safe way to induce vomiting or administer activated charcoal at home.

• Induced vomiting
• Gastric lavage
• Activated charcoal

Animals that develop gastrointestinal and CNS symptoms will require stabilization and supportive care:

• Seizure medication (diazepam)
• GI protectant drugs: to prevent gastric ulceration
• Vomiting medication

Animals that develop hepatic failure require aggressive supportive and symptomatic care:

• IV fluid therapy
• Liver protectants
• Vitamin K: to reduce hemorrhage risk
• Blood transfusion

Prognosis for sago palm poisoning varies in accordance with the amount of toxin ingested and the timing of treatment.

Animals treated in the subclinical phase carry a good prognosis. If the treatment is delayed and the animal exhibits GI and CNS symptoms, the prognosis is guarded to poor. In severe cases, animals develop hepatic failure and carry a poor prognosis. Severely affected animals may die despite medical attention as the result of blood loss and shock.

In all cases, prompt medical attention is crucial in increasing the likelihood of a positive outcome.

Sago palm poisoning is not contagious. The condition is entirely preventable by ensuring animals do not ingest the plant.

Strategies include:

• Not planting Cycads
• Removal of indoor plants
• Elimination of sago palms from yards and gardens
• Keeping dogs on a leash during outdoor activities in unknown areas
• Researching potential toxic plants prior to planting or buying
• Proper disposal of leaves and other plant parts

Pet poison hotlines are seeing a spike in calls regarding sago palm poisoning due to increased availability and popularity of the houseplant.