DEATH BY CHOCOLATE Ralph, a 6-month old pug, was regularly spoiled with treats from the grocery store.

His owner Jean was charmed by his puppy antics, and by his apparent sweet tooth. She was dismayed, but not surprised, to come home one day to discover that Ralph had managed to open a cupboard and chew into an 8 -oz. box of unsweetened baking chocolate. By the time she found him, half of the box was gone - both cardboard and chocolate. Jean cleaned up the mess, scolded Ralph, and thought no more about it. Even when he vomited a few hours later, producing masses of chocolate mixed with cardboard, she felt it was to be expected given the circumstances. But a short time later Ralph took a turn for the worse. He returned again and again to his water bowl, and appeared to be trembling, and he galloped around the house in an advanced state of excitement. Jean checked his heart rate and found that it was very fast, at about twice normal. She called the veterinarian, Dr. Brown, who wanted to see Ralph immediately. By the time Ralph arrived at the vet's office he had begun to have seizures and was in a coma. Dr. Brown started supportive measures at once. She explained that chocolate, especially unsweetened chocolate, contains significant amounts of plant alkaloids called theobromine and caffeine, and that these chemicals are much more toxic to dogs than to people. She estimated that the 4 oz of chocolate that Ralph ate probably contained about 1600 mg of theobromine, and a much smaller amount of caffeine. These compounds have similar biological effects, but it is the relatively high concentration of theobromine in chocolate that caused most of Ralph's problems. The supportive measures for Ralph included diazepam, a tranquilizer, and phenobarbital, a sedative, to control the dog's hyperexcitability and potential seizures. The vet also monitored Ralph's heart for signs of arrhythmia. Since Ralph wasn't conscious, it wasn't safe to induce vomiting to get rid of the undigested chocolate, but it was possible to introduce charcoal into his stomach to absorb any remaining chocolate, and then pump his stomach. Caffeine and theobromine belong to a special class of amines called methylxanthines. Dogs do not metabolize methylxanthines as readily as humans -- the compounds instead recirculate again and again, and clear only slowly from the canine body. The effects on a dog's nervous system can last for a long time. It takes 17.5 hr for half of a dose of theobromine to leave a dog's body, and only 6 -10 hr for the same dose to leave a human's body. As the toxic dose for a dog is 100-150 mg/kg and the lethal dose is approximately 250 mg/kg, it is obvious that Ralph was gravely ill. Ralph would actually have been much better off if he had eaten milk chocolate or even semi-sweet chocolate since the amount of methylxanthines in these is

much lower. Both kinds of chocolate are still dangerous to dogs, however, as dogs have been known to eat large quantities of chocolate.

Unfortunately, in spite of the intensive (and expensive) support measures Dr. Brown undertook, Ralph died after three days in a coma. Jean felt guilty that her carelessness allowed this to happen, and she was determined that no future pet of hers would have this lethal opportunity. Although the methylxanthines act on the human body in much the same way as on the canine body and produce similar effects, the human body can eliminate them much more efficiently. The mass of a human is also much greater than the mass of a canine. Humans do often notice the effects of caffeine when they drink coffee. In coffee, the caffeine concentration is much higher than the theobromine concentration, but the development of unpleasant symptoms would prevent a human being from drinking enough coffee to be dangerous. A cup of coffee with about 100 mg of caffeine is generally regarded as safe.