What Is Acetaminophen Toxicity?
Acetaminophen is the active ingredient in Tylenol and some other related medications that are used to treat pain and fever in people. Unfortunately, this drug can be extremely toxic (poisonous) to cats and dogs. Acetaminophen toxicity occurs when a cat or dog swallows enough of the drug to cause damaging effects in the body.
Acetaminophen is mostly metabolized (broken down and eliminated from the body) by the liver. Some of the substances that are created during this process can have harmful effects on cats and dogs. Cats are at much greater risk of toxicity than dogs because they lack certain proteins necessary for the liver to safely metabolize acetaminophen.
How Does Acetaminophen Toxicity Occur?
Many cases of acetaminophen toxicity in dogs and cats are accidental. A pet may find and chew on a bottle of pills or eat a pill that has fallen on the floor. Sadly, some cases occur because pet owners give medication intended for people to their pets without being instructed to do so by a veterinarian.
Acetaminophen is a drug meant for people. However, there are situations in which your veterinarian may prescribe a specific dosage of acetaminophen for your dog. Be sure to follow your veterinarian’s dosage directions very carefully and report any vomiting or other problems right away. Cats are 7 to 10 times more susceptible to acetaminophen toxicity than dogs are. Because cats are extremely sensitive to the drug’s toxic effects, acetaminophen is not given to cats.
What Are the Clinical Signs of Acetaminophen Toxicity?
Once swallowed, acetaminophen is rapidly absorbed from the stomach and intestines and can achieve significant levels in the blood within 30 minutes. The main toxic effects take two forms:
Cats and dogs can develop both forms of acetaminophen toxicity. However, cats are more likely to suffer hemoglobin damage while dogs are more likely to suffer liver damage. The main clinical signs associated with acetaminophen toxicity that result from liver injury and an inability of the blood to carry oxygen include:
How Is Acetaminophen Toxicity Diagnosed?
Diagnosis of acetaminophen toxicity is commonly based on a history of recently chewing or swallowing pills. Your veterinarian may recommend diagnostic testing, such as a chemistry panel and complete blood cell count (CBC), to assess the extent of the damage.
What Are the Treatment and Outcome for Pets Suffering From Acetaminophen Toxicity?
Acetaminophen is absorbed and metabolized very quickly. If you realize right away that your pet has swallowed acetaminophen, vomiting can be induced to remove the drug from your pet’s stomach before the body can absorb it. Another option may be to anesthetize your pet in order to flush out the contents of the stomach. Your veterinarian may also administer a special preparation of liquid-activated charcoal to slow absorption of toxic material from the stomach and intestines.
There is a specific antidote for acetaminophen toxicity. This medication, N-acetylcysteine, limits formation of the toxic substance that damages the liver and red blood cells. Additional treatments may include blood transfusions, intravenous fluid therapy, and other medications to help support and stabilize the patient.
Acetaminophen toxicity can be fatal. However, pets can survive if the condition is recognized, diagnosed, and treated quickly.
Most cases of acetaminophen toxicity are preventable. Never give medications meant for people to your pet unless instructed to do so by your veterinarian, and keep all medications in the home secured to help prevent accidental swallowing.
How Can I Make the Travel Experience Better for My Cat?
Our pets share so much of our lives that many of us don’t want to consider traveling without them. Whether you are flying, driving a car, or RVing, sharing a trip with a pet can add richness to the experience. Proper planning can make the travel experience better and less stressful for you and for your pet.
What Food and Medications Should I Bring When Traveling With My Cat?
There are many factors you can’t control when you are on the road, but changing your cat’s food can cause vomiting, diarrhea, or other problems that can be difficult to deal with while traveling. Some cats may even refuse to eat a different food; if this refusal goes on for a few days, it can quickly turn into a problem. You can help avoid this problem by bringing enough of your cat’s regular food for the duration of the trip. If your cat receives medication, bring enough for the trip and try to maintain your regular schedule.
If you are traveling by car or RV, set up a large cage or crate with your cat’s litterbox, food, and water; bringing your cat’s favorite bed, blanket, or toys can also help make the trip more relaxing and pleasant. If you are flying, you will need an airline-approved carrier for your cat; you should also request that your cat fly in a temperature-controlled cargo area.
Many people escape the snow by traveling with their pet to warmer climates. Although fleas and ticks may not be a problem during the winter where you live, your cat may be exposed to these parasites at your destination. Make sure you’re prepared by asking your veterinarian for appropriate flea and tick control products.
How Should I Plan for Travel With My Cat?
Spontaneity and family emergencies aside, most of us wouldn’t take a trip without planning some things ahead of time. The same thing applies when traveling with your cat:
Where to stay: Many hotels and rental properties allow pets. Locating proper accommodations ahead of time and being clear about fees (some places charge an extra fee for pets) can help minimize anxiety when you arrive.
Travel requirements: Most airlines require a health certificate for pets that will be flying. The health certificate generally states that the pet is in good health and free from any infectious or contagious diseases. Don’t assume this document can be obtained from your veterinarian on the way to the airport! Your cat may need a physical examination, fecal exam, or other procedures before your veterinarian can sign a health certificate. Also, the certificate must be obtained within a certain window of time before you travel. Find out from your airline what their requirements are and plan to get the health certificate ahead of time.
Some destinations (particularly island locations like England and Hawaii) may have quarantine regulations or rabies certification procedures. Clarify any of these requirements well in advance of your trip.
Medical care: Do you have a plan in case your cat gets sick while you are traveling? If possible, find a veterinarian at your destination; your own veterinarian may be able to make some recommendations. This is particularly important if your cat has an existing medical problem or is on medication.
Should I Sedate My Cat for Travel?
Giving a tranquilizer to a cat before traveling has pros and cons. Some would argue that if your cat is tranquilized, then he or she is not sharing the travel experience with you—so what is the point of bringing your pet along? Sedation can also have side effects, including lowering body temperature (which could be an issue if your pet is flying in the cargo area of a plane), and causing hypotension (low blood pressure). Others may argue that a little light sedation can calm a cat that is overly stressed or excited while traveling and can therefore make the trip more pleasant for everyone involved. There is no one-size-fits-all answer to this question. Some cats do very well with a light sedative, but remember that sedation does not address all travel issues. If your cat has severe motion sickness or gets extremely stressed while traveling, it may be better to arrange for a pet sitter or board him or her. Also, not every cat is a good candidate for a tranquilizer, so ask your veterinarian if sedation is a good idea for your cat.
If you have never given your cat a tranquilizer before, give a test dose ahead of your trip. Pick a day when you will be home with your pet for most of the day. That way, if the medication causes excessive sedation or other negative side effects, you will be there to intervene and call your veterinarian for help.
What Else Should I Know About Travelling With My Cat?
If you plan to travel with your pet, let your veterinarian know ahead of time. He or she may be able to advise you about parasite protection and other health considerations that may be different at your destination. If you decide to leave your cat at home, your veterinarian can likely recommend a good boarding facility or pet sitting service. Addressing any questions or concerns with your veterinarian ahead of time can save worry and stress while you are away.
It is recommended that you identify your pet even if you don’t plan to let him or her go outside. Even “indoor” pets can get out by accident, and many lost pets are never returned to their owners because they have no identification. Collars and tags are popular, effective methods of identification, but they can come off. Microchips, which are implanted just under the pet’s skin, are one way to permanently identify pets.
What Is a Microchip?
A microchip is a tiny electronic device—about the size of a grain of rice—that uses radio waves to transmit stored information when it is read by the right kind of scanner. Microchips for pets generally store a unique identification number. They do not need a power source, and they have no moving parts, so they do not wear out. Microchips are made of a material that is compatible with body tissues, so rejection and infection at the site are rare.
After injection, the microchip becomes encased in the tissue at the injection site. It may move slightly, but it usually stays at or near the place it was injected. To read the chip, a compatible scanner must be passed over it. Different microchip companies use different chips; however, there are scanners that can read all kinds of chips.
The Microchipping Procedure
Many veterinary offices have the equipment to implant and scan for microchips. Each microchip comes preloaded in a sterile syringe. To implant the chip, the veterinarian inserts the needle just under the pet’s skin between the shoulder blades and pushes the syringe plunger. The entire procedure, like a regular injection, is very quick and does not require pain medication or anesthesia.
How the System Works
When a lost or injured pet is taken to an emergency room or shelter, he or she can be scanned for the presence of a microchip. If the pet has a chip, the scanner reads the pet’s identification number. If the chip has been properly registered, the shelter or hospital can provide the number to the microchip company, which maintains the owner's contact information. The microchip company then contacts the owner, and the pet can go home.
Microchip Registration and Maintenance
#1 Asparagus Fern
Asparagus fern (also called emerald feather, emerald fern, sprengeri fern, plumosa fern, and lace fern) is toxic to dogs and cats. The toxic agent in this plant is sapogenin—a steroid found in a variety of plants. If a dog or cat ingests the berries of this plant, vomiting, diarrhea, and/or abdominal pain can occur. Allergic dermatitis (skin inflammation) can occur if an animal is repeatedly exposed to this plant.
#2 Corn Plant
Corn plant (also known as cornstalk plant, dracaena, dragon tree, and ribbon plant) is toxic to dogs and cats. Saponin is the toxic chemical compound in this plant. If this plant is ingested, vomiting (with or without blood), appetite loss, depression, and/or increased salivation can occur. Affected cats may also have dilated pupils.
Dieffenbachia (commonly known as dumb cane, tropic snow, and exotica) is toxic to dogs and cats. Dieffenbachia contains a chemical that is a poisonous deterrent to animals. If this plant is ingested, oral irritation can occur, especially on the tongue and lips. This irritation can lead to increased salivation, difficulty swallowing, and vomiting.
#4 Elephant Ear
Elephant ear (also known as caladium, taro, pai, ape, cape, via, via sori, and malanga) contains a chemical similar to the one in dieffenbachia, so an animal’s toxic reaction to elephant ear is similar: oral irritation, increased salivation, difficulty swallowing, and vomiting.
Many plants of the lily family are considered toxic to cats, and some are considered toxic to dogs. Cats are the only animals in which the Easter and stargazer lilies are known to be toxic. Generally, a cat’s first toxic reaction to this plant includes vomiting, lethargy, and a lack of appetite, but severe kidney failure, and even death, can quickly follow if a cat is untreated. The peace lily (also known as Mauna Loa) is toxic to dogs and cats. Ingestion of the peace lily or calla lily can cause irritation of the tongue and lips, increased salivation, difficulty swallowing, and vomiting.
Cyclamen (also known as sowbread) is a pretty, flowering plant that is toxic to dogs and cats. If ingested, this plant can cause increased salivation, vomiting and diarrhea. If an animal ingests a large amount of the plant’s tubers—which are found at the root, generally below the soil—heart rhythm abnormalities, seizures, and even death can occur.
#7 Heartleaf Philodendron
Heartleaf philodendron (also known as horsehead philodendron, cordatum, fiddle-leaf, panda plant, split-leaf philodendron, fruit salad plant, red emerald, red princess, and saddle leaf) is a common, easy-to-grow houseplant that is toxic to dogs and cats. This philodendron contains a chemical that can irritate the mouth, tongue, and lips of animals. An affected pet may also experience increased salivation, vomiting, and difficulty swallowing.
#8 Jade Plant
Jade plant (also known as baby jade, dwarf rubber plant, jade tree, Chinese rubber plant, Japanese rubber plant, and friendship tree) is toxic to cats and dogs. The toxic property in this plant is unknown, but ingestion of it can cause vomiting, depression, ataxia (incoordination), and bradycardia (slow heart rate; this is rare).
#9 Aloe Plant
Aloe plant (also known as medicine plant and Barbados aloe) is a common, succulent plant that is toxic to dogs and cats. Aloin is considered the toxic agent in this plant. This bitter, yellow substance is found in most aloe species and may cause vomiting and/or the urine to become reddish.
#10 Satin Pothos
Satin pothos (also known as silk pothos) is toxic to dogs and cats. If ingested by a cat or dog, this plant may irritate the mouth, lips, and tongue. The pet may also experience an increase in salivation, vomiting, and/or difficulty swallowing.
For a full list of toxic and non-toxic indoor and outdoor plants, visit the American Society for the Prevention of Cruelty to Animals (ASPCA) website at www.aspca.org or The Humane Society of the United States website at www.humanesociety.org.
Why Does My Cat Need Injectable Medication?
Certain medications, such as insulin, can only be administered by injection. Depending on the formulation and the type of medication, injectable medications can be given by several routes. They can be given through direct injection into a vein (known as intravenous, or IV injection), injection into a muscle (known as intramuscular, or IM injection), or injection directly under the skin – a procedure known as subcutaneous (SC orSQ) injection. It is very important that you understand how your pet’s injectable medication needs to be given; for example, if you accidentally give a medication intravenously instead of subcutaneously, complications can result. Most injectable medications given at home are intended to be given subcutaneously.
Before you start, ask your veterinary health care team for training and advice so you know how to give injectable medication without injuring yourself or your cat. If you aren’t comfortable or need additional training sessions, don’t be afraid to ask!
Here are a few things to consider:
The “syringe” is the clear (usually plastic) cylinder that holds the medication to be injected. The “needle” is the sharp, metal tip that is injected into the skin. The “plunger” is a stem that moves inside the syringe. Pull the plunger backward to fill the syringe and push it forward to empty the syringe. A new needle/plunger and syringe are sterile until they are opened. The bottle of injectable medication is also sterile. It is important to handle these items properly to avoid contaminating them. Your veterinary care team will show you how to properly open a syringe and draw up injectable medication without breaking sterility. Be sure to use a new syringe, plunger, and needle for each injection. Reusing syringes and needles can cause infection. Additionally, a used needle is dull and therefore more painful than a new needle.
Some cats are happy lying or sitting on your lap while you administer the medication injection. However, you should place a towel or blanket across your lap (to avoid getting scratched) in case your cat tries to jump down. Some cats do better on a smooth surface, such as a table; the surface of a washing machine can simulate the smooth metal table at your veterinarian’s office and encourage your cat to remain still during the procedure. Additionally, some cats do better with two people administering the injection – one person to hold the cat and the other one to give the injection.
Giving a Subcutaneous Injection
Your veterinary care team will show you how to administer an injection before you have to try it alone at home:
Giving an Intramuscular Injection
There are a few precise areas on the body that are commonly used for giving intramuscular injections. You will need to find “landmarks” on your cat so that you know where to give the injection. Your veterinary care team will show you how to find an appropriate injection site and administer an intramuscular injection before you have to try it alone at home:
Ask your veterinary team to teach you how to administer medication injections safely. If you aren’t comfortable giving injections, ask about scheduling outpatient visits for the injections to be given.
Understanding the Medication Instructions
The first part of successfully administering medication to your cat is to ensure that you understand the instructions for giving the medication. These instructions include route of administration (for example, by mouth, into the ears, or into the eyes), dosing frequency (for example, once daily, every 12 hours, or every 8 hours), duration of treatment (for example, 7 days, until gone), and other special considerations (for example, give with food, follow with water).
Sometimes there is flexibility with medication instructions; for example, some medications can be given “as needed,” or a twice-daily dosing schedule may be adaptable to once-daily dosing. However, for other medications, the recommended dosing instructions need to be followed closely. Before you leave your veterinarian’s office with a new medication, be sure to address any concerns or questions regarding the medication with your veterinary team. For example, if your work schedule does not permit dosing every 8 hours, your veterinarian may be able to recommend a different medication that can be given less frequently. Ask about your pet’s expected response to the treatment.
It is very helpful to write a medication schedule for your pet on a calendar, including the date and time that the medication needs to be administered. This will help you to (1) avoid forgetting to give a dose and (2) remember when the course of treatment is completed. It is also very important to follow all label directions carefully. Improper storage (for example, keeping a refrigerated medication at room temperature) can affect the safety and effectiveness of medication. Additionally, it is important to give the medication for the correct length of time. Complications can occur if antibiotics are not given for the full duration of recommended treatment; in addition, some medications (such as corticosteroids) cannot be discontinued without causing illness, so it is very important to give medications as directed. If your pet experiences any medication-related side effects, contact your veterinarian promptly for advice before adjusting a dosage or discontinuing the medication.
If you’ve never given a cat medication before, it can be difficult to know what method will work best. Some cats take pills very readily if the pill is hidden inside a treat or given with a small amount of canned cat food. Another option is canned tuna or salmon for people. Pills can also be crushed (or capsules broken and emptied) and mixed with a small amount of canned food. However, your cat must eat all of the food right away to ensure receiving the full medication dose. Also, some coated pills and capsules have a bitter taste if the capsule or coating is removed. If the medication makes the food taste badly, your cat may refuse to eat it. Before choosing one of these options, ask your veterinarian if the medication can be given with food. You will probably know after the first or second dosing if this method will work.
If you must give your cat a pill directly by mouth, here’s a method that usually works. This technique takes practice and may require more than one attempt to get your cat to swallow the pill. If your cat is not used to having your hands around his or her mouth (as with toothbrushing, for example), gradually introduce your cat to this by stroking your cat’s face and neck for a few moments. This should calm your cat. If you think that your cat may try to bite or scratch, do not attempt this technique; ask your veterinarian for alternative medication options:
Administering Liquid Medication
Some pet owners prefer liquid medication because administration does not require placing your fingers inside of your cat’s mouth. However, if your cat refuses to swallow the liquid, this method may not be ideal. Here are some tips for administering liquid medication:
If you are unable to administer medications to your cat, here are some suggestions that may help:
What Are Subcutaneous Fluids?
Fluid administration is a regular part of veterinary medical care. Any time that a patient is dehydrated or needs fluids, your veterinarian determines the best way to provide them. Fluids can be given by mouth, injection into a vein (known as intravenous fluids or IV fluids), or injection directly under the skin – a procedure known as subcutaneous fluid administration.
If a pet is able to eat and drink, giving fluids by mouth may be an option. However, if the pet is vomiting, unwilling to drink, or unable to obtain enough fluids through drinking, other methods of fluid administration must be considered. To receive intravenous fluids, pets generally need to be hospitalized because only a small amount can be given at a time and the IV catheter (through which the fluids are given) requires special care and maintenance. However, subcutaneous fluids can be given in larger amounts over a relatively short period of time, so hospitalization is frequently not required. The injection of sterile fluid is given under the skin and absorbed slowly over the next several hours. Advantages of the subcutaneous route include a lower cost (no catheter is required, and hospitalization is often not necessary) and ease of administration.
When Are Subcutaneous Fluids Necessary?
Cats being treated for chronic kidney disease are the most likely to receive subcutaneous fluids on a regular basis. Your veterinarian may also recommend subcutaneous fluids for pets that are vomiting or unable (or unwilling) to drink adequate amounts of water. Examples may include cats receiving chemotherapy, cats with liver disease, or cats with a high fever.
Depending on the medical condition being treated, your veterinarian may recommend fluid injections daily, every other day, or a few times a week. The frequency of injections and the amount of fluids given at each injection may change over time, so be sure to keep a notebook detailing when fluids are given and how much.
Before you get started, your veterinary health team will work with you to make sure you know how to give the subcutaneous fluid injections without injuring yourself or your cat. If you aren’t comfortable or need additional training sessions, don’t be afraid to ask!
Here are a few things to consider:
The new fluid bag, fluid line, and needles are sterile until they are opened. It is important to handle these items properly to avoid contaminating them. Your veterinary care team will show you how to assemble the fluid line and bag and to attach a fresh needle without breaking sterility. Be sure to change the needle after each injection; the fluid line can be changed when each bag of fluids is completed.
For the fluids to flow from the bag and into your pet, the fluid bag must be suspended over the area where your pet is sitting. Many pet owners use a bent wire coat hanger to hang the fluid bag over the top of a door; you can then sit in a nearby chair and hold the cat while fluids are being given.
Your cat may be happy lying or sitting on your lap while you administer the fluid injection. However, you should place a towel or blanket across your lap (to avoid getting scratched) in case your cat tries to jump down. Some cats do better on a smooth surface, such as a table; the top surface of a washing machine can simulate the smooth metal table at your veterinarian’s office, which might encourage your cat to remain still during the procedure. Additionally, some cats do better with two people administering the injection – one person to hold the cat, and the other one to give the injection.
Giving the Fluid Injection
Your veterinary care team will show you how to administer fluids before you have to try it alone at home:
Ask your veterinary team to teach you how to administer fluid injections safely. If you aren’t comfortable giving injections, ask about scheduling outpatient visits for the fluid injections to be given.
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