IBUPROFEN, ACETAMINOPHEN, ASPIRIN TOXICITY

Over-the-counter drug poisoning is one of the most common poison exposures for small animals. One of the most commonly consumed medications responsible for poisoning dogs and cats are non-steroidal anti-inflammatory drugs (NSAIDS), the category includes aspirin, ibuprofen and acetaminophen. These drugs appear in hundreds of prescription and non- prescription formulas (including Pepto Bismol, Alka-Seltzer, numerous muscle liniments). They are administered to pets by pet-owners to relieve symptoms associated with fever, arthritis or other painful conditions. Unfortunately, NSAIDs can be very dangerous when ingested by cats and dogs.

What can happen and which parts of the body can be affected:

Stomach and intestinal ulceration and perforation and leakage of the stomach content into the abdominal cavity.

Kidney failure.
Liver failure.
Anemia and bleeding.
Seizures.

Symptoms you may see after ingestion:

General: Pale or yellow (icteric) gums, weakness, stumbling, unable to walk, crying, panting or shallow breathing, hematomas underneath the skin or prolonged bleeding from even small wounds. Difficulty breathing, coma, death.

Gastrointestinal: Vomiting with or without blood, diarrhea with or without blood, black tarry stool, not eating or decreased appetite, malodorous breath.

Nervous system: Lethargy, depression, seizures.

Urinary system: Bloody urine or not urinating at all.

What tests will your veterinarian want to perform:
Blood work, urinalysis and abdominal x-rays or ultrasound.

Treatment:

There is no antidote for most NSAID toxicity.
Vomiting will be induced if the pet is conscious and not seizing or in coma and if the ingestion was within 2-3 hrs. Gastric lavage will be performed in animals who are not responsive to decontaminate the stomach.
Activated charcoal then will be administered every 4-6 hours to reduce the drug re-absorption. Activated charcoal has been associated with hypernatremia, as many charcoal preparations draw water into the gastrointestinal tract. Signs of hypernatremia include ataxia, tremors, seizure and coma. That is why all animals should be monitored in the hospital for these signs for a period of four hours after administering charcoal.
Intravenous catheter and balanced fluids will be necessary to maintain urine production and to combat dehydration.
If your pet is not urinating enough, urinary catheter will be inserted to closely monitor urine production. Medications to prevent or treat stomach ulceration will be started.

How to induce vomiting at home if you can’t go to an animal hospital:

Hydrogen peroxide (3 percent) is a gastrointestinal irritant. Administer a dose of 1 to 2 mL/kg orally, not to exceed 45 ml (3 Tablespoons) which may be repeated once if vomiting has not occurred within 20 minutes. Hydrogen peroxide can by syringed to the pet or mixed with a small amount of appealing food (peanut butter, milk, ice cream) to encourage the animal to ingest it. Increasing the animal’s activity may encourage vomiting. Use with extreme caution in cats as they are more sensitive to hemorrhagic gastritis, which can be life-threatening.
Your veterinarian has much more powerful and safer injectable drug called Apomorphine, that will produce emesis rapidly in dogs, so if you have time, please bring your pet into hospital.