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Green is not always good. In this week’s episode, Dr. Amanda Zetwo recounts her experience with her two dogs, Faith and Moses, when they happened to eat something they weren’t supposed to while out at a park one winter’s evening. Hear Dr. Zetwo’s harrowing tale of Vitamin D (cholecalciferol) toxicosis and what she went through to save Faith and Moses’s lives from this newer form of rat bait. Learn what you can do to protect your pets from this potentially fatal toxin.

Welcome, Dr. Zetwo!

[00:01:04] Dr. Lancellotti: Welcome, everyone, to today’s episode of Your Vet Wants You To Know. We have a special episode today talking about cholecalciferol toxicity, which is a type of rat bait. To talk about this particular toxicity, I have with me, Dr. Amanda Zetwo, who not only is very knowledgeable about this particular toxin, but also went through a very personal experience of her own. I’m so thankful that she has come to share that experience with everyone in hopes that it can help some other pet owners in the future, to either avoid this or help guide them through the situation that they may be in. Thank you very much for being with us, Dr. Zetwo.

[00:01:46] Dr. Zetwo: Thank you so much for having me. I recommend your podcast and this is such a great resource for owners. 

[00:01:53] Dr. Lancellotti: Thank you so much. So, just to give our listeners a little bit of a background- you are originally from Pittsburgh and you’ve been practicing in veterinary medicine in some way, shape, or form for almost 20 years now. But you and I were classmates together at Western University in California when we went to veterinary school- which was wonderful. I loved hiking with you and your husband, Greg, and having you guys over for Sunday family dinners. It was a really nice time together. 

[00:02:21] Dr. Zetwo: Yes. Those were definitely the highlights of California, for sure.

[00:02:24] Dr. Lancellotti: Yeah. And then after graduation, you worked in a hybrid general practice ER hospital out in California and then moved back to Pennsylvania. 

[00:02:35] Dr. Zetwo: Yeah, we did. It was really great experience out there. I thought we were going to stay out there for a while and life happens and we ended up coming back towards the East coast. I’ve worked a couple jobs out here- mainly general practice and emergency. All the species (domestic, exotic, avian, etc.)- if it walked through the door, I’d see it.  

[00:02:56] Dr. Lancellotti: And now you are medical director for Animal Friends Clinic and Community Services. Congratulations. 

[00:03:03] Dr. Zetwo: Thank you. That kind of fell into my lap, as well. I was working a full-time job at the ER general practice I was at, but I really missed surgery. The local clinic needed some help with spay and neuter and various surgeries, so I started doing relief there one day a week or a couple of times a month, and it blossomed into a really nice opportunity. In January of 2020, I started there full time and we’ve now grown it to have a general practice, a mobile surgical unit, dentistry, vaccine clinics, high quality/high volume spay/neuter, but also various soft tissue and orthopedic procedures as well.

[00:03:48]Dr. Lancellotti: It sounds like you get to do a lot of really interesting things throughout the course of the day and the practice offers a lot to the community. 

[00:03:56] Dr. Zetwo: It does. It’s a nice affordable option, especially with COVID. Pet retention is our number one goal. So, what can we do to keep that pet in the home? Do they need food? We have Chow Wagon.  We’ll get food delivered to them, or if they just need affordable vet care, we’re just helping to control the population and just keep that pet with that family.

Dr. Zetwo holds a kitten
Dr. Zetwo snuggles a happy patient.

Faith and Moses's Story

[00:04:14] Dr. Lancellotti: That’s wonderful. What a beautiful mission. So you are going to tell us a story today about some of the pets that you have in your home- you have two dogs, a blind cat and a rabbit, but we’re going to focus on those two dogs, what happened with them, and the connection with the topic for today. Why don’t you go ahead and tell our listeners what you’ve been through and a little bit about cholecalciferol? 

[00:04:39] Dr. Zetwo: Okay. Well, we have Faith. She is a 13 year-old female, spayed Australian Shepherd. She’s pretty much my best friend. She’s been with me through everything. She was the flower girl in our wedding. She moved from Pennsylvania to California and then back again. Just this summer, we added Moses, a male Australian Shepherd puppy into our home, and we’ve been working on training with him. So, Sunday night before Christmas, we decided to go down to this field in our neighborhood and do some off-leash recall training. It was about 8:00 PM at night, it was dark because it was winter, and we had about three inches of snow on the ground. At one point, Faith and Moses were chomping away at something, so I called them off and they listened. I just assumed it was deer or bunny poop- aka manna from Heaven for dogs. We just had a normal night and came home the next morning. At about 7:30 AM, I’m getting ready for work, and Faith vomited three bright green round logs about the size of a Tootsie roll and had some yellow bile. Literally, my first thought on seeing the green color was, “Oh my God. That’s rat bait.” But the consistency was different to what I’m used to seeing. It was more moldable versus a crumbly block, so I thought there’s no way this is rat bait. We live in Seven Fields (PA), which at one point was the third safest township in the country. We were literally right beside a playground. It’s an open field. There are woods and a stream. I literally thought, because we were by a playground, “I bet a kid dropped (green) Play-Doh while playing. So, I don’t know. I guess it was denial! So, I took pictures, I collected the green logs in a plastic bag, and I posted this to a veterinary emergency group I’m in. I told Greg, “Hey, you’re on standby. I might call you to bring the dogs in,” and I headed off to work. Then, I started to get some responses. Everything from, “Oh, I bet it’s goose poop to wasabi (I thought that was a really clever one because it really looked like wasabi), but the most reoccurring comment was that’s rat bait until proven otherwise. So, I check the material under the microscope and it wasn’t goose poop. My technician called the ASPCA Poison Control, and she gave them the gist of the story and got an account set up. Then, a toxicologist called me back and that doctor was just so helpful. I was able to send him pictures of what I had that morning, we talked about the different consistency, and he educated me that in 2018, d-Con started transitioning their rat bait from a vitamin K product to a vitamin D product. Vitamin K- everybody  knows that one. That’s the one where it will not allow your pet to form a blood clot. So, they’ll eat it and like 3-5 days later, they might start just slowly bleeding into their belly and their chest. So, now it’s a vitamin D formula, and they also came out with a new cake formula- you can actually mold it like Play-Doh into shapes. So, you can put it around things versus the hard, solid blocks that I was familiar with. He helped me create a decontamination plan and just give me a wealth of information. 

[00:08:29] Dr. Lancellotti: Yeah, that ASPCA Poison Control line is so valuable. I really feel like every pet owner should have the information to be able to call the Poison Control line as soon as they think something is up, so that they can establish an account and talk to the services that they have there. It’s really helpful in trying to figure out exactly what the danger level is for an animal, based on what they ingested, their body weight, etc. Then, the ASPCA Poison Control toxicology veterinarians will work with the emergency room veterinarians to come up with a treatment plan. It’s definitely an invaluable resource for pet owners. If you are a pet owner, that is a ‘must have.’ 

[00:09:21] Dr. Zetwo: Agreed. 

Cholecalciferol (Vitamin D) Toxicity

[00:09:22]Dr. Lancellotti: I did an episode with Dr. Monica Sterk, where we talked about the vitamin K specific rat bait. So if you’re interested in learning more about the the classic vitamin K toxicity and rat poison that’s a great episode to listen to, as well. Dr. Zetwo, tell me a little bit about cholecalciferol- this different type of rat poison. What is it used for and how does it work?

[00:09:50] Dr. Zetwo: Cholecalciferol is actually vitamin D (D3 specifically). You might be thinking, “How can can a vitamin be toxic? Especially, when D3 is added to milk and butter, and it’s found naturally in egg yolks and the sun. It helps build strong bones and teeth, and it helps with your muscles and nerves, but vitamins can be toxic if they are fat soluble. When you hear “vitamin,” you tend to think of “water-soluble,” like vitamin C and vitamin B. And if your body doesn’t need more than it has in it, it’s just going to pee out the extra. But, the 4 vitamins that are fat soluble are vitamin K, A, D, and E (KADE). So, any extra vitamin D in your pet is going to be stored in the fat and the liver for future use, but too much of that can actually be toxic. 

[00:10:55]Dr. Lancellotti: If we are suspicious that the pet has eaten this rat bait, and if the pet owner has actually seen the pet eat the poison or the pet has vomited it up (like Faith did), what information would be important to tell the veterinarian so that they can come up with a diagnostic and treatment plan?

[00:11:12] Dr. Zetwo: That’s a great question. The more information, the better. Rat bait is usually green in color, so that’s your first clue. If you see a pet chewing on a green block or vomit anything that is green, an alarm bells should go off. There are a few different types of rat bait out there and they all work a little differently. The most common thing I heard while I was on ER is that people had recently moved and their pet found a green block in the basement, in a kitchen corner, the attic, or a shed in which the previous owner had put it out. With this rat bait, the most likely first thing you could see in your pet is a lack of appetite, followed by them drinking more, urinating more, and then they’re not going to want to drink or eat or make any urine. There could be vomiting, diarrhea, belly pain, lots of drooling, looking weak, and even seizures.  

[00:12:11]Dr. Lancellotti: So that’s, if a pet owner doesn’t see the animal eat the rat bait, those would be the first thing is that they would see? 

[00:12:17] Dr. Zetwo: Yes. A couple of days later, once it’s been absorbed, that could be one of the first things you see. It’s important to tell your vet as much as possible about a timeline and pertinent details as possible- such as when your pet may have eaten the rat bait, possibly how much, the consistency and color of any vomit or stool, where your pet has been in the last 2-3 days, and where possible contamination may have occurred. If your pet does vomit or have a bowel movement, bring that with you to the ER. If you put out the rat bait and you still have the original packaging, bring that with you as well. Also a reminder that this toxicity can come from not just rat bait, but if a pet may get into a vitamin supplement or a bottle of vitamin D, this potentially could occur depending on the dose. I know with COVID right now, I’m personally taking extra zinc, vitamin C, and vitamin D to help boost my immune system, so I have bottles of all of that in my medicine cupboard right now. Many Americans are low on their vitamin D and maybe taking a supplement, as prescribed by their doctor. And this reminds me of a story. Once on emergency, I had a client packing to go on a week long trip and she was putting all of her prescriptions and vitamins into a Ziploc bag for each day of the trip. Then, she left the room, and when she’d come back, the dog had eaten all of the bags. 

[00:13:46] Dr. Lancellotti: Oh no! 

[00:13:47] Dr. Zetwo: Yeah. Poison Control, again, was just an absolute lifesaver that day. She called ahead and she read off every prescription medication, the strength, how many were in the total bags, and she read off each vitamin and what was in every one of them. So, by the time she came into the hospital, Poison Control and I already had a treatment plan and we were ready to go to start treating the second that dog walked in.

[00:14:14] Dr. Lancellotti: That’s wonderful. It sounds like she was prepared, as far as getting ready for her trip, but then also prepared, as far as bringing her dogs into the emergency room. 

[00:14:22] Dr. Zetwo: That pet was not a first time offender. She was very familiar with Poison Control. 

[00:14:27] Dr. Lancellotti: Oh no! Let me guess, was it a lab?

[00:14:30] Dr. Zetwo: It was actually a Jack Russell. 

[00:14:32] Dr. Lancellotti: Okay. They can be just as bad.

[00:14:36] Dr. Zetwo: I would have thought a lab though! 

[00:14:38] Dr. Lancellotti: So, if the pet owner has seen the animal eating this particular type of rat bait, or they get into a vitamin D supplement, or if this is something that the veterinarian suspects, what sort of tests should a pet owner expect the veterinarian to recommend? And what are they looking for? What did you test Faith and Moses for? 

[00:14:58]Dr. Zetwo: Definitely be prepared for a lot of blood work. This is a really intense toxicity and values can change really quickly, so at least daily blood work for a couple of days to a week, and if they’re hospitalized, potentially even multiple times a day checking levels.    

[00:15:15] Dr. Lancellotti: And what exactly are we looking for in those levels? Where is the vitamin D going to be affecting the body and how is that going to change the blood work values? 

[00:15:25] Dr. Zetwo: Great question. Basically, too much vitamin D is going to turn the kidneys and the heart and other soft tissue organs into bone, which is no good. To make sure that’s not happening, we’re going to be looking at mainly calcium and phosphorus values in a chemistry panel, among a few others. Those two can go high and potassium can go low, so we want to check those at least daily for 4 days and making sure that they’re not trending upward each day. 

[00:15:56]Dr. Lancellotti: And so what did you see with Moses and Faith?

[00:16:01] Dr. Zetwo: With Faith, she’s an adult, so her values fall into the adult range. I was checking those daily and there were slight elevations, but they never hit a critical threshold. But Moses is a puppy, so he has growing bones. His calcium and phosphorus values are already higher being a puppy versus an adult range, so having a baseline number (starting on Monday) and checking it each day was really important to make sure that that his values weren’t trending upward, because we already started with values that were technically out of the normal range.  

[00:16:39]Dr. Lancellotti: So it’s not just where one single value is, it’s important for the veterinarian to see what’s happening on different days, over a course of time. 

[00:16:50] Dr. Zetwo: A hundred percent. There can also be some blood clotting issues as well, so at the appropriate time, you want to check a clotting panel. A vitamin D panel may or may not be recommended. It’s a fairly academic test to run. With vitamin D, you don’t want to run that panel until it’s already been absorbed by the body. So we wouldn’t run that on Monday within 24 hours of them getting the toxin. You’d want to check it at like day 3-5 to see if those levels are high, but by that time, your pet’s already going to be showing clinical signs and a lot of us won’t run a test unless it’s going to change how we’re going to treat the pet. I did run it in Faith and Moses just because I was curious, and the value was mid-range, which helped me make sure it wasn’t at a catastrophic level.

Dr. Zetwo comforts her dogs during treatment.

How is Vitamin D3 Rat Bait Toxicity Treated?

[00:17:43] Dr. Lancellotti: Yeah. So we’ve gone through a little bit about what you might see when this happens and what sort of tests the veterinarian’s going to do. How about treatment? How are these pets going to be treated and what should pet owners expect during that process? I know that not every animal is going to be treated the same, but how might the treatment differ based on how long the poison’s been in the body? 

[00:18:09]Dr. Zetwo: First, it’s important to note that there is no antidote for this. There are things we can do, but there’s no magic reversal for pets or children that could ingest d-Con. Honestly, I was envisioning having to euthanize them both on Christmas Eve if they were dying and it absolutely destroyed me to picture that. 

[00:18:28] Dr. Lancellotti: That’s heartbreaking. I’m so sorry you went through this. 

[00:18:32] Dr. Zetwo: Thank you. It definitely was an educational opportunity and hopefully we can help others from it. I felt that if they were going to have a bad outcome from this, at least if I couldn’t change the outcome, I could change the process and give them that gift, versus letting them suffer and their last few days or hours be really painful. 

[00:19:00] Dr. Lancellotti: Yeah. 

[00:19:01]Dr. Zetwo: That said though, I was ready to try everything and fight with whatever I could to keep them here. We started with inducing vomiting again. That was a bit overkill, as Faith had already vomited that morning (which was just a gift that she did). She has always had this weird gut. And like clockwork, if she ate something she shouldn’t have or that didn’t agree with her, right at about 12 hours she would bring it up. She got into a corn cob once and brought it up. Cooked potato another time- just random. But I’m really glad she kind of has that. Making Moses vomit was a bit of a hail Mary because at 12 hours post-exposure, it almost definitely absorbed. And I can’t explain why Faith didn’t absorb it, but I got lucky with it still being in her stomach that morning. My guess is that it was wrapped in some delicious meat and that absorbed before the blocks did. So I figured I’d at least try for Moses. He was empty. No blocks- which meant he either digested any he did eat or that maybe Faith got to all of them before he had a chance. With Faith, she had brought up 3, but I didn’t know if maybe she ate 7 and 4 were digested or if any were left, so it was worth a shot. And then I also put on gloves and I combed through their poop from the last night and that morning, and then all future bowel movements for about 24 hours (that’s true love right there), and I didn’t see any further green material. Unfortunately, with most poisoning cases, there’s usually more questions than answers. 

[00:20:40] Dr. Lancellotti: You are very lucky that Faith has whatever the opposite of a stomach of steel is. She just wanted that out of her body. I have to say, there are some really wonderful pictures of Dr. Zetwo and her husband, Greg, working with Faith and Moses during this ordeal and Moses having a trash bag around his neck for this induction of vomiting. So you guys can check out those pictures on the website. Also, to see how adorable the dogs are too. 

[00:21:13] Dr. Zetwo: Thank you. 

[00:21:13] Dr. Lancellotti: So tell us a little bit about how to induce vomiting and what comes next. 

[00:21:19]Dr. Zetwo: We induce vomiting with an injection of a medication and it works very well. That’s just kind of a nice little ER pro tip there. Put a plastic bag over the dog, cut a hole out for their head and it’ll help keep them clean from the vomiting. And then, the recommendation was to give activated charcoal to both dogs. Activated charcoal comes in a liquid and it’s thought to help bind and clear the toxins. Again, this is ideally given within a few hours of ingestion, but there was really very little downside to giving it at 12 hours post-exposure, so we tried it. Most dogs will not eat this willingly and you have to syringe it orally, so they want to spit it out, it dribbles out, and pretty much everything in a five-foot radius is going to be covered in charcoal- people included. 

[00:22:13] Dr. Lancellotti: And charcoal, for those who are not familiar with it, is as black as you can get and it will get everything black. 

[00:22:20] Dr. Zetwo: Yes. And it will stain. With Moses being a goofy, derpy puppy, we took a chance and we mixed his charcoal with really yummy canned food and he actually ate it, so he was the MVP of the day. 

[00:22:35] Dr. Lancellotti: Good for him! 

Dr. Zetwo's husband, Greg, comforts Moses, while he wears a trash-bag around his neck to keep him clean while vomiting is induced.

[00:22:37]Dr. Zetwo: Yeah! But for Faith, we had to syringe it. And we’re not talking like a small amount here. We’re talking like 2-3 cans of Pepsi- trying to get that kind of volume down into a dog that doesn’t want it. 

[00:22:50] Dr. Lancellotti: Not an easy task. 

[00:22:51] Dr. Zetwo: No. And so then we gave fluids to both of the dogs because the solution to pollution is… 

[00:22:58] Dr. Lancellotti: Dilution. 

[00:23:00] Dr. Zetwo: That was probably the best thing I learned in vet school. So, it couldn’t hurt and it’s going to help hydrate the body, we’re going to make the kidneys happy, and we’re going to flush out the toxins. So, that was just one more thing we did that day. Then, the toxicologist at ASPCA recommended a medication. I had never heard of it before, but it was called Cholestiramine, which is used in human medicine for lowering cholesterol, among a few other things. The thought was that it could help bind the excess vitamin D in the body and help clear it from the liver, but it comes in a really horrible powder that is citrus-flavored. I don’t know a single dog or cat that likes citrus, but again, it was a human medication and I was willing to try anything. But we also had to make sure it wasn’t the human diabetic formula because those packets are sweetened with xylitol, which is fine for people, but is toxic to dogs- so I didn’t want to have a second poisoning. But we ended up finding it, the pharmacist was super helpful, and we had to give that every 8 hours for 4 days like clockwork. We were setting alarms and waking up in the middle of the night. The last dose was actually Christmas morning, which was kind of a nice way to end it. We had to mix it into a ton of different foods. Baby foods, gravies- just anything to try and get Faith to take it. Again, Moses would eat it in canned food. He was actually fine, but Faith ended up getting sick from it. She developed a condition called pancreatitis, but thankfully, I could manage that at home and she didn’t need to be hospitalized. I also got really nervous because the first sign (that we could see) of vitamin D poisoning would be her not wanting to eat. So I couldn’t tell. “Do you not want to eat because there is a horrible citrus powder in your food, or because your kidneys are failing?” That was not a fun game to play for a couple of days, but we got through it. With rat bait, the crappy thing is by the time a pet starts showing signs, you’re usually 3-5 days into the poisoning and the prognosis is really guarded. The best chance of treating this is within 4 hours, and being able to decontaminate them by inducing vomiting, giving activated charcoal, fluids, checking blood work, etc. But if they eat it, and you don’t see it happen, usually they have already absorbed it. Depending on the dose, the outcome could be really sad. So while for Faith and Moses, I did most of the treatments at home and I was able to run into work each day, most people are going to need to plan to admit them to a hospital with 24 (hour) care and plan on that being a couple of days, potentially up to a week. If they are showing signs of poisoning, it could even be longer. 

[00:25:56] Dr. Lancellotti: Yeah. These dogs definitely need a lot of supportive care, and a place that has 24-hour-a-day facilities is going to be really crucial in making sure that they are given the supportive care that they need to get their bodies through this. With Faith and Moses, they were about at around 12 hours after ingestion when you found out what was going on with them? 

[00:26:20] Dr. Zetwo: Yeah, so I was in slightly unchartered waters. Working in ER, I don’t think I have ever had a case that was in between, like Faith and Moses. Every case that I can remember- either (number 1) owners saw them eat the rat bait (or medication, a bottle of supplements, etc.) and they immediately called us and brought their pet in, where I could induce vomiting within hours of them eating something that they shouldn’t have and start treatment. And all of those pets actually did really well. If you can decontaminate within that 4-hour window and get the charcoal and everything into them, you usually have a much better prognosis. Or (number 2) it was days after they ate the rat bait and the pet owner had no idea until their pet was sick. Some of those cases had a good ending, albeit an expensive experience due to very intensive care and treatments, and some had some really sad endings. I think that’s the hardest part of this. It’s not their fault that they ate it. You know? They didn’t know what it was going to do. The innocence of a pet being duped into eating something that could kill them is just really hard to take as a healer. 

Moses eats charcoal mixed in dog food while wearing a trash bag to keep him clean.

How can pet owners prevent Vitamin D rat bait toxicity?

[00:27:37] Dr. Lancellotti: Yeah. I’m sure as the pet owner too. We don’t intend for our pets to get into these things and, unfortunately, it happens. But fortunately, there are a lot of really experienced veterinarians, not only in emergency rooms, but also with the ASPCA toxicology service. They are there to try and help get through these crises. This whole ordeal that you went through sounds incredibly nerve-wracking. What would you say pet owners can do to help prevent this from happening to them? 

[00:28:07]Dr. Zetwo: I even talk about some of these recommendations at puppy visits, trying to just prepare people. Because if you have a puppy, it’s not an ‘if’ but a ‘when’ they’re going to eat something that they shouldn’t have, or something’s going to drop on the floor. So my recommendations are (I’ve got a couple for you)- 1. Keep medications in a really safe place. And I know that’s obvious, but it serves repeating. 2. Train a solid “leave it” command, in case you drop medication and your pet is nearby, or you drop some food that could make them sick- anything. You want to be able to say, “Leave it,” and they know what that means. 3. I would watch out for pet food recalls. Vitamin D is added to food, milk and butter, pet food, etc. Accidents can happen, so just be aware of any alerts that come out about a food recall. 4. If you move into a new home, I would scour every nook and cranny inside and outside for open bait blocks. There are these black boxes that house rat bait, and those are considered child and pet-friendly because you can’t touch the physical block. The animal should go into the black box, chew off a piece of the bait, and then go back to their home. But I know a lot of dogs that like to chew and will chew anything, so don’t let your guard down and be aware of what’s in your home. And then, unfortunately, there is just true evil in the world and people who will maliciously set out rat bait where children and pets could get to them. We were literally right by a playground. A child could have picked up these logs and eaten them. Why this is available over the counter, and not through a licensed professional exterminator, raises a good question just about safety. I would love to see that change in my lifetime. Or at least the black boxes, where the bait is contained and is pet and child-friendly- for them to be available over the counter would be a step in the right direction, versus just having access to the blocks in their raw state. We were bordered by a stream and a set of woods by the playground, and we do get a lot of wildlife in our neighborhoods, so it’s possible someone was intending this bait for wildlife. But again, that raises very serious safety and humane questions. 

[00:30:27]Dr. Lancellotti: That’s another good reason to have the “leave it” command trained because you guys were out by the park. You didn’t expect there to be anything the dog shouldn’t get into, but unfortunately, there was something there. Faith and Moses, they’re very good and I’m sure they listened as soon as you said, “leave it,” but unfortunately, in that case, it was a little bit too late. They had already gotten into it. I’m sure after going through and talking about Faith and Moses throughout this episode, our listeners are dying to know. After everything you went through, what happened with them?

[00:31:02] Dr. Zetwo: Well, thank God, they are okay and that they’re still here with us. Christmas day was extra special because it was the first day in over 96 hours that I could take a breath. We weren’t completely out of the woods, but we were starting to feel hopeful. And thankfully, each blood work has been good, it’s just scary because Faith is a senior (geriatric). If she would have went into kidney failure, I probably would have just thought, “Oh, old age. That’s unfortunate.” I would’ve never thought vitamin D. I’m just so thankful that she vomited those blocks, that they pulled through, and that they are still here with me today. 

[00:31:41] Dr. Lancellotti: I bet. Now, I don’t know Moses, but I know Faith and she is a truly remarkable dog. What an absolute blessing it is that she just vomited those blocks up.

[00:31:54] Dr. Zetwo: And I’m just so thankful that I saw her vomit those blocks up. My husband is very intelligent, but he might have just thought, “Well, those are weird,” thrown them away and told me when I got home from work that night, “Oh, Faith vomited this morning and there was something green in them.” But (it was great) to have the experience and have that warning of, “Hey. This looks like rat bait.” 

[00:32:19]Dr. Lancellotti: Yeah, I’m really thankful that they’re doing great. That’s wonderful, Dr. Zetwo. Wonderful.

[00:32:24] Dr. Zetwo: Thank you. 

[00:32:25]Dr. Lancellotti: Now pet owners know. Anything vomited that’s green should send off a big alarm bell that it’s time to call the ASPCA Poison Control as quickly as possible. Green is not good in this situation. 

[00:32:38] Dr. Zetwo: Agreed.  

[00:32:40] Dr. Lancellotti:  If you as a listener have been through some type of toxicity and have had to go to the emergency room with your pet, I would love for you to share your story with other listeners in our Facebook group. You can join and tell us about what you went through and help to educate other people so that they don’t go through the same thing. 

Scratching the Itch

[00:33:23] I like to end each episode with a segment called Scratching The Itch. This is something that either provides relief or just makes you feel good. Hence, scratching the itch. Dr. Zetwo, I know that you have a really remarkable ‘scratching the itch’ for us today. I’m so excited for you to tell this story because it is truly inspiring. Please, share with us your ‘scratching the itch.’

Dr. Zetwo and her husband crossing the finish link of an IronMan race

[00:33:50]Dr. Zetwo: My ‘scratching the itch’ has to be doing triathlons. This is a neat one for me because it is so not something in my wheelhouse. It’s not something I’m naturally good at. In fact, the first half marathon I ever saw was with you and Stephen, where we were cheering him on at the Disneyland Half in 2011. I just remember thinking there is no way I could ever run 13.1 miles. I had a bunch of personal health issues and whatnot over the years. If we fast forward to my 30th birthday; the day after it, I started an immunosuppressive medication (a four-hour-long infusion to calm down my overactive immune system). And I was pretty down about that. I felt pretty bad about myself and that my body wasn’t doing what it should. And a couple weeks or months into the treatment, I actually started to feel better, at 30, than I did in all of my teens and 20s. About six months later, it was April, and I was talking to a friend. I said, “In one year, I’m going to run the Pittsburgh half marathon (which was a year later in May) and I started training. I did one of those “couch to 5k” apps and those are fabulous. I can’t say enough about those. Those are great. There’s some walking and running and I started increasing my distance. And of course, I got injured. I pulled a muscle in my leg and then, I was all depressed again because I knew it took me so long to get where I was. My friend recommended, “Hey, why don’t you swim and bike to keep up your cardio?” so that I wouldn’t lose all the progress I made. So, I joined the YMCA and it was bad. It was not graceful. The YMCA lifeguard, who was probably 70, was going to be the person to rescue me. But I had more faith in his swimming skills that I had in my own, so it was okay. I mean, I couldn’t even do a lap. I could not get the breathing down. I would stick my head out of the water and exhale correctly, but then I would stick my face in the water and inhale. I didn’t even go into the deep end. I would just swim where my feet could still reach, turn around and do laps that way, because I was afraid of the deep end. It was bad. I was winded. Yeah- not a natural athlete here. Basically, I just kept going, even when my foot started to feel better, because it was really good cross-training. I thought, “Well, I’m already swimming, biking, and running- screw it. Let’s sign up for a triathlon.” So that May, I actually did run and finish the Pittsburgh half marathon.Then, in July, we did the Rev3 Williamsburg Virginia Sprint Triathlon, which is a short distance called a sprint. It’s only a 500 yard swim, a 15 mile bike and a 3.1 mile run. It’s a great distance just to get your feet wet, and it was just the nicest environment. For the person who comes in last, they actually radio and send somebody to run with you, and all the volunteers gather around the finish line, they open champagne, and they make a really big deal out of it. It’s super motivating. I didn’t come in last at that run, but it was really nice to watch like, “Oh, this is what they do. So I kind of thought all races did this. I was wrong. So Greg and I got really hooked and we’re like, “Let’s sign up for one the very next month.” Literally, it was the beginning of July and the next one was August 19th. And it was double the distance! It was a 750 yard swim, a 30 mile bike and a 6.2 mile run. We had no training and we’re like, “We can do it.” And I won’t call that a mistake, but it was definitely a learning opportunity. I choked on the swim and I (literally halfway in the water) was like, “I’m going to quit.” But then I realized, “Well, I’m halfway. I pretty much would have to swim back or get on one of the kayaks.” So I just finished it. Then, I got on the bike. One of the hills was so steep that I actually had to get off my bike and walk it up the hill. Then, a little chaser car came around, pulled up to Greg and I, and they asked, “Are you guys the last ones?” And I looked at the guy and I said, “Well, we probably are if you’re asking that.” And he drove off. There was no, “Good luck,” or “You can do it.” He just drove off. So then, we started the run and I passed a woman and I was like, “I passed somebody! I’m not going to be last! Score!” Then, I finished my second lap and Greg and I crossed the finish line, and the entire place was deserted except for one guy with two medals, who promptly handed us our medals, got in his car, and left. There was no water, no beverages, like nothing. It was deserted. Apparently, the girl I had passed dropped out and didn’t finish her second run lap. So, we actually did finish last. But there’s a really great acronym in triathlons that goes, DFL > DNF > DNS. This stands for, ‘dead flipping last’ is greater than ‘did not finish’ which is greater than ‘did not start.’ And that just really speaks to me. 

[00:39:26] Dr. Lancellotti: I love that so much. That’s such a powerful statement. 

[00:39:30] Dr. Zetwo: Isn’t it? That just really gets to me. And so, less than a year later, Greg and I traveled to Canada and did a Half Iron Man in Victoria, on Vancouver Island. A Half Iron Man is a 1.2 mile swim, a 56 mile bike and a 13.1 mile run, and you need to do it in about under 8.5 hours. And for me, it’s truly about the finish line. I don’t care what my time is. It’s more about a challenge that I chose versus one that’s picked for me, like health issues. They say that 90% of a triathlon is just knowing how to suffer. I went to vet school. I know about that. So, it’s just that mindset of, “This is what I’m doing today. I can’t be reached for the next eight hours. I get to stop when I cross the finish line.” And there is something just super empowering and very freeing about that- even if you suck at it. 

[00:40:28] Dr. Lancellotti: Well, it sounds like, at this point, that you no longer suck at it. You and Greg have been really doing an amazing job with these races and it’s so inspiring to see how far you’ve come. I’m really, really impressed, and this certainly did make me feel good and scratch the itch for me. Thank you. 

[00:40:45] Dr. Zetwo: Thank you. 

[00:40:48]Dr. Lancellotti: I am so thankful for you coming on the show and sharing your story of Faith and Moses. I really hope it helps to educate some people and prevent some disasters in the future, so that people are more aware of what to watch for and what to do if they find themselves in this situation. Thank you so much, Dr. Zetwo, for sharing this story with our listeners today. 

[00:41:08] Dr. Zetwo: Absolutely. Thank you so much for having me. 

[00:41:11] Dr. Lancellotti: And for all of our listeners, I look forward to your next visit you to know.

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