Toxin for one, toxin for all

Randy and Giselle Winters of Deerfield Beach, Florida, obtained some reef fish from the Bahamas and decided to grill it for their family. The duo feeds Love Bug, their 6-pound Chihuahua, and Honey Bear, their older Pekingese, a mostly fresh-food diet such as chicken, rice, and potatoes. To them, the fish scraps were a special treat for the two dogs. However, the fish the Winters prepared was contaminated with ciguatoxin, which causes ciguatera poisoning.

According to a release from Pet Poison Helpline, ciguatoxin is a neurotoxin that alters nervous system function. The toxin is produced by dinoflagellates—marine algae that grow in and around coral reefs. These algae are ingested by smaller fish, which are then eaten by larger, commercially important species such as grouper and snapper. Ciguatoxin is harmless to fish but poisonous to people and their pets.

Love Bug in the oxygen box after ingesting reef fish contaminated with ciguatoxin (image courtesy of Pet Poison Helpline)

"Pets are severely impacted by ingesting ciguatoxin," warned Renee Schmid, DVM, DABT, DABVT, senior veterinary toxicologist and Director of Veterinary Medicine at Pet Poison Helpline, in the organizational release. "If humans eat fish contaminated with ciguatoxin, it can affect their digestive and nervous systems and, in severe cases, their cardiovascular system."

Ashley Brown, PharmD, CSPI, Senior Clinical Toxicologist and Manager of Clinical Toxicology for SafetyCall (human side), explained that it is impossible to determine if a fish is contaminated because ciguatoxin does not change the fish’s appearance, odor, or taste. It can affect people whether the fish is fresh or previously frozen, and it is heat-stable, meaning cooking does not destroy the toxin.

Once everyone ate the contaminated fish, they began exhibiting symptoms including loss of appetite, diarrhea, and vomiting. The human family members went to the emergency room for treatment, and the dogs were taken to BluePearl Pet Hospital in Fort Lauderdale, Florida, after they continued to show symptoms.

"Although ciguatera poisoning isn't typically fatal in humans, anyone who has ingested the toxin should seek emergency care immediately to prevent serious complications," said Schmid. "Because of their small size, Love Bug and Honey Bear were impacted far more severely. In addition to vomiting and diarrhea, they became lethargic; Love Bug was unable to stand, disoriented, and exhibited labored breathing."

Love Bug and Honey Bear both received intravenous fluids and antibiotics and were kept overnight for observation. Because of her smaller size, Love Bug’s reaction was more severe: she was placed in an oxygen chamber and given specific medications to address neurologic signs. She remained hospitalized for several additional days. When both pets returned home, they required continued nursing care until their symptoms fully resolved.

"Their loss of appetite was so severe that we had to feed them with syringes," Randy Winters explained. "Fortunately, the dogs’ symptoms cleared up after a few weeks. My wife and I, however, experienced lingering neurological effects for six months—continued body aches and temperature reversals (cold feeling hot). We were placed on a strict diet, including no alcohol."

Patients may also present with muscle and joint pain, temperature reversal, and unique sensations such as a metallic taste, loose or painful teeth, or skin paresthesias. These symptoms can last for weeks to months and may reappear if patients consume certain foods or drinks, such as nuts, fish oils, or alcohol.

According to Schmid, cats are even more sensitive to ciguatera poisoning and can serve as sentinel species for human risk, often becoming ill more quickly and after ingesting smaller amounts of toxin.

"My heart goes out to our furry girls, Love Bug and Honey Bear, who endured this pain without the ability to express it," Giselle Winters said. "I feared we would lose Love Bug—she dropped to just 3.2 pounds after the oxygen chamber, losing nearly half her body weight. Thankfully, both dogs have fully recovered and are enjoying life as usual, thanks to the incredible medical care they received."

Reference

Entire Family, Dogs Included, Poisoned by Reef Fish. News release. Pet Poison Helpline. May 14, 2025. Accessed May 14, 2025. https://prnmedia.prnewswire.com/news-releases/entire-family-dogs-included-poisoned-by-reef-fish-302454493.html