JACKSONVILLE, Fla. – When my 1-year-old boxer puppy came running into the porch with what looked like a mini tree in her mouth two years ago, I didn’t think much of it.
Actually, that’s not true.
I thought it was hysterical.
Joey always brought in giant leaves or sticks that were longer than she was (see below). A tiny “tree” was just par for the course.
I grabbed my cellphone and snapped a picture that I posted on Instagram later, along with some of her other puppy antics. I made sure she took the “tree” back outside.
I never saw what she did with it after that.
But the next morning, I got a pretty good idea. She threw up. A lot. And not to be gross, but I saw all these seeds and wood-looking pieces in it.
I swear an angel must have whispered it to me because out of nowhere, it suddenly rushed back to my memory that we had a sago palm in our backyard.
I knew those could be poisonous to dogs.
I was so thankful I had snapped that photo. I whipped out my phone and pulled up the pic while my husband did a quick Google search. We compared the photos.
Sure enough, that was exactly what she’d had in her mouth.
We realized she was also drooling way more than normal. A ton more.
That was on the symptom list for sago palm poisoning — along with vomiting.
We threw her in the car and called our vet on the way. Based on what we’d read, there was no time to lose. She hadn’t been outside unsupervised that morning before she threw up, so it was likely the seeds had been in her system since the night before, possibly as long as 12 hours.
We knew she needed treatment right away.
Dr. Justin Fyfe with Pet Doctors of America, part of the team who treated Joey, said one to two sago palm seeds can be enough to cause liver failure in a 40-pound dog.
“But we never use the number of seeds as guidance. It’s just, ‘Did you get into it or did you not get into it?’ Just because we don’t know how much of it does it actually take,” Fyfe said.
WATCH: Press play below to hear Dr. Fyfe explain the signs and symptoms of sago palm poisoning:
He and Dr. Matt Mizesko, one of the vets at First Coast Veterinary ER who also treated Joey, explained that the full toxicity of sago palm is not completely understood.
What is known is that ALL parts of a sago palm are toxic, and the most toxic part is the seeds.
“We say that mainly because the seeds are usually what the animals get into,” Mizesko said. “Most animals are not just going to go chew on the leaves, because they’re prickly. But most of them will go play with the seed, and that’s usually what it starts at is playing with the seed and then, you know, they’re animals, so they’re curious.”
In Joey’s case, we had the evidence of her getting into the seed pod, along with the vomiting and the drooling, and that was enough for the first vet who saw her at Pet Doctors of America to diagnose her with sago palm poisoning.
Fyfe said typical symptoms can include vomiting, excessive drooling, diarrhea, lethargy and lack of appetite. Dogs that have more severe cases can become jaundiced because their liver has already been damaged by the toxins.
“The clinical signs that you see are kind of nondescript, so they’re clinical signs that we can see with a lot of stuff. But it’s kind of just putting all these puzzle pieces together,” Fyfe said. “Something that can be really helpful to us is that if you do have a suspicion they got into something in particular — bring it with you. We don’t care how dirty or nasty it is. We’ve seen it all.”
Fyfe said just collect a sample in a plastic bag and bring it with you to the vet so they can help identify what made your pet throw up.
Mizesko said, starting around April, he and his colleagues at the ER will see an average of three to five cases a week of sago palm poisoning, but thankfully, about 90% of those will recover just fine in a few days.
Mizesko said he’s lost two patients in five years to sago palm poisoning. Fyfe said it’s been five years since he’s lost a patient to it, but he sees only a few cases of it a year compared to what the ER deals with.
“It’s a very common toxicity that we’ll see here,” Mizesko said. “If caught early, as in the owners saw the animal chewing on it or they bring them in typically within four to six hours of ingestion, nine out of 10 of those dogs are going to do great. They’re going to be here one to three days, but they’re going to go home typically.”
The good and bad thing about sago palm toxins is that they attack the liver. The good thing is that the liver is the rare organ in the body that can regenerate itself. The bad thing is that “the liver does everything,” Mizesko said.
“The question is, can you keep the animal stable while the liver is regenerating itself and sometimes the answer is no,” he said.
Thankfully in Joey’s case, the answer was yes.
She was immediately placed on liver support medications and IV fluids, and her liver readings never spiked during her three days of treatment.
“She was lucky,” Fyfe said.
But it was an ordeal for her and for us.
Our vet was treating her during the day but didn’t have overnight care, which is where First Coast Vet ER came into the mix. We picked her up every evening, shuttled her to the overnight care at the ER, then picked her up in the morning to shuttle her back.
It was tiring, stressful — and expensive. (We’re talking thousands of dollars expensive.) But my baby girl was worth it.
In the end, four different veterinarians worked together to save Joey.
And she is what Mizesko would consider a “mild to moderate” case.
WATCH: Press play below to hear Dr. Mizesko explain the treatments for sago palm poisoning:
He said his ER sees about half dozen really bad cases a year that end up in the hospital anywhere from five to seven days and end up needing vitamin K treatments or even plasma.
“The couple of cases that we’ve had pass away are the dogs who get into such large amount that they start to have seizure activity. Those dogs tend to succumb within 24 hours,” Mizesko said.
He said most of the cases that come in, though, will go home in one to two days if the owner caught it early.
He said treatment typically starts with induced vomiting, then nausea meds and activated charcoal.
The vet will then track liver values, electrolytes and hydration status over 24 hours, and put them on an IV pump to help balance out what they lost from the vomiting and nausea.
The liver treatments are typically denamarin, a liver cell regeneration medication, and acetylcysteine, which prevents liver cell death. He said you’ll sometimes see bodybuilders use acetylcysteine.
He said vets won’t reach for vitamin K treatments or plasma unless the dog’s lab results show they’re absolutely necessary.
Needless to say, neither Fyfe nor Mizesko is a big fan of sago palms. Neither am I, for that matter.
We got rid of ours as soon as we could after Joey’s nightmare.
And that’s Fyfe’s advice to dog owners who see a sago palm in their landscape.
“The best sort of treatment plan is avoiding toxic plants. When I moved in my house, we had one growing in our backyard, and it was literally the first thing I did when we bought the house is dig it out,” Fyfe said. “A lot of people just don’t know what’s in their yards. They just know it’s a pretty plant. And we don’t realize that these things are toxic to animals.”
And plant sellers aren’t required to tell you.
Yeah, I was surprised by that, too.
But I learned while working on this story that the U.S. Consumer Product Safety Commission doesn’t have requirements for warning labels on house or yard plants.
Tonya Ashworth, an extension agent with the University of Florida’s Institute of Food and Agricultural Sciences in Duval County, explained that it’s not as simple as slapping a “toxic” label on plants, however.
“Where would they draw the line? Because there are so many that could be considered toxic or poisonous but the level of toxicity (varies),” Ashworth explained. “It would be a real hard thing to put a label on because it’s not like: this one is toxic, this one is not.”
Ashworth, who specializes in environmental horticulture, pointed out another particular difficulty with regulating sago palms: only the female plants are dangerous because they make the poisonous seeds. And because the plants being sold are likely seed-grown, the sellers might not even know if they’re selling a male or a female plant, she said.
You can’t tell until the plant is mature enough to either make a cone (male) or make seeds (female).
So, it’s up to pet owners to know what’s in their own yard, and perhaps even in their neighbors’ yards, Mizesko warned.
“A lot of people also get confused because they’ll see their dogs chewing on these seeds and they don’t have any sago palms in their yard,” he said. “This season, especially, the spring or summer, a lot of birds are going to drop the seeds into other people’s yards.”
But he said there’s a group of botanists on Facebook who will help. If you caught your pet chewing on something and you’re not sure what it was, you can take a picture of the seed and upload it to the group and someone will help you identify it. But they only work on an emergency basis.
Knowing what’s in your yard
And Ashworth said she can help you figure out what’s in your yard before things go bad.
If there’s a plant that you’re concerned might be poisonous, take some quality photos of it and email them to Ashworth at firstname.lastname@example.org, and she will try to help you identify it.
Unfortunately, Ashworth said, there’s no easy mantra to learn for poisonous landscape plants. No “leaves of three, let it be” to help us out here, sorry.
“There’s nothing that screams: ‘I’m a poisonous plant,’” Ashworth said. “There’s so many of them. There’s not like a list of five — learn these five and you’re good. You just kind of have to know.”
And Ashworth emphasized how important it is to know, especially if you have pets or young children.
“Try to identify what’s in your yard and learn whether or not it’s poisonous, especially if you have young children that don’t know any better or dogs that you notice like to chew on grass — like my dogs like to munch stuff when we go outside,” Ashworth said. “If you think you’ve got a muncher, then it’s important to look around and notice what kind of plants that you have.”
And Mizesko pointed out that many times the plants in and around our homes weren’t our choice.
“Most of the time when people buy houses, the sago palms are already at the house, so they’re not watching the landscaper put it in,” he said. “It’s instantaneous landscaping and they look good. They’re very easy to maintain.”
Even if they are deadly.
So how can you tell what’s what around your home, especially if you didn’t put it there?
Aside from bombarding Ashworth with emails, there are some resources that can help.
The ASPCA has a list of plants toxic to pets that includes photos to help you compare to what’s in your yard. Not surprisingly, one of the top searches on the ASPCA page was for sago palms.
And during our conversation for my story, Ashworth discovered an app created by the UF/IFAS Extension Office that can help you identify toxic Florida plants. Just go to https://ffl.ifas.ufl.edu/resources/apps/toxic-plants/ and click Go to the App at the bottom of the page. It’s free and doesn’t require a download.
The app includes sections for palms and cycads (like sago palms), shrubs, vines, weeds and more. Each entry includes pictures, plus details on the parts of the plant that are toxic and what symptoms it might cause in both humans and animals.
Joey has gotten into a few more scrapes since her sago palm misadventure. She’s a boxer, after all (boxer owners will definitely know what I mean).
Overall, though, she’s doing well and loves playing with her older sister, our Jack Russell terrier rescue, Chloe.
But she still hates going to the vet.
Who can blame her?