My dog ate a whole bar of dark chocolate 30 min ago

Alright, a classic but potentially serious one. We're well within the window for effective decontamination. Here's the plan.

My Decontamination Specialist confirms the immediate steps. Since ingestion was only 30 minutes ago, we need to get that chocolate out now.

Induce emesis immediately. Use apomorphine at 0.03 mg/kg IV.

Administer activated charcoal. After the vomiting stops, give activated charcoal at 1-2 g/kg PO. The initial dose can contain sorbitol to act as a cathartic.

While you're getting that started, my Dose Calculator needs more information to determine our level of concern. The dose makes the poison, and we need to do the math. Please get me the following:

* The dog's weight in kilograms.
* The weight of the chocolate bar in ounces or grams.
* The cacao percentage, if it's on the wrapper.

This calculation is critical. It will tell us if we're likely to see mild GI signs (20 mg/kg), cardiac signs like tachycardia (40-60 mg/kg), or if we need to be concerned about seizures (>60 mg/kg).

Based on that mg/kg exposure, we'll decide if hospitalization for IV fluids, cardiac monitoring, and repeat charcoal doses are necessary. Theobromine has a long half-life and undergoes enterohepatic recirculation, so high doses require aggressive management.

Start decontamination now and get back to me with those weights.

☠️ Dr. Nguyen

Good, you've got them within the ideal window for decontamination. Let's get that out of them before significant absorption occurs.

My primary concern is emptying the stomach and minimizing systemic uptake. Here is the standard ER approach:

Induce Emesis: Your most reliable option is apomorphine.

* Dose: 0.03 mg/kg IV. The conjunctival route is also effective if you have the tablets.
* Expect vomiting within minutes. Assess the vomitus to confirm you've recovered the chocolate.

Administer Activated Charcoal: Once emesis has stopped, administer activated charcoal to bind any remaining theobromine.

* Dose: 1-2 g/kg PO. Use a product containing sorbitol for this first dose to act as a cathartic, but do not repeat the sorbitol.

Establish IV Access: Place an IV catheter and begin crystalloid fluid therapy. This provides a route for any emergency drugs needed later and promotes diuresis to help excrete the toxin. A maintenance rate is fine for now unless the patient is already showing clinical signs.

I'll defer to Dr. Nguyen for the toxic dose calculations based on the dog's weight and the specific chocolate percentage. She will provide the specific monitoring parameters for tachyarrhythmias and neurologic signs, which are the primary risks once the toxin is absorbed. My job is to get it out; hers is to manage what's already in.