Almost on a daily basis, we will take some sort of medication. This will range from over the counter pain relievers to prescription medications. We, as a society, have almost become reliant on these medications, and we do not give them a second thought. However, what we take is not always a good thing for our pets. Over the counter pain medication can be extremely dangerous to our household pets.

Tylenol has been in our medicine cabinets for many years. I can remember when the only two choices were aspirin and acetaminophen. This medication, however, can be extremely dangerous to our cats. If a cat ingests this common medication, it will interfere with the cat’s ability to take oxygen into their body properly.

How can a relatively benign medication in humans cause such damage in a cat? Cats can lack an enzyme called glucuronyl transferase. This enzyme takes acetaminophen and turns it into a relatively benign chemical. If this enzyme is not present, it can cause liver damage and changes in the cat’s red blood cells. Specifically, the red blood cells undergo oxidative changes, and they are not able to take up oxygen properly. They are also seen as damaged by the body, and the body will eliminate them. These two processes will lessen the body’s ability to absorb oxygen into the bloodstream and carry it to the organs that need it.

So, what can I expect if my cat has eaten one of these pills? One of the first symptoms you may see is weakness. If the organs are not getting the oxygen needed to sustain themselves, the cat will be very weak and lethargic. Their gums may even become pale, and they may exhibit rapid breathing. As this damage progresses, the gums and urine may turn brown. If your cat exhibits any of these signs, they will need to be seen immediately. Your veterinarian can run test to determine how severe the damage is and they can suggest treatments to help to turn this around.  

If you are sure that your pet has ingested a pill, your veterinarian will induce vomiting as soon as possible and they will also give activated charcoal to decrease the absorption of the medication. Once this has begun and the testing is finished, they will be given blood transfusions and fluid therapy. If there are not enough red blood cells in the body, they will need to be replaced as soon as possible. Most clinics have blood donors readily available and we are fortunate to have an animal blood bank available at East Metro Animal Emergency Clinic. There is also an antidote available to the acetaminophen, N-acetylcysteine. The next steps are supportive care and patience. If there is not permanent damage to the liver and the pet receives care in a timely manner, there is a good chance of survival.

The other, probably more common, over the counter pain medication is ibuprofen. Many people take this medication for anything from headaches to chronic pain. However, once again, it is not good for our pets. If our dogs or cats ingest the medication it can cause a variety of symptoms. They may exhibit vomiting, diarrhea, bloody stools, bloody vomitus, weight loss, stomach ulcers or perforations, lack of coordination, and even seizures.

When our pets take this medication, it acts on the COX pathway. This is short for cyclooxygenase. One pathway is responsible for inflammation and the other is responsible for helping to form a protective layer called the mucosal barrier in the gastrointestinal tract, for the flow of blood to the kidneys, and for regulating platelet function. Ibuprofen is very effective in stopping the inflammation portion of the COX pathway, and that is why it is so commonly used to control pain in the human population. However, in the animal population, the therapeutic dosage is essentially the toxic dosage.

We cannot ever give our pets ibuprofen. When they are given ibuprofen it will affect the formation of the mucosal layer in the gastrointestinal tract. This can lead to vomiting, diarrhea, and stomach ulcers or perforations. It will also alter the flow of blood to the kidneys, and this can ultimately lead to kidney failure. Lastly, it will inhibit the ability of platelets to clump. This leads to unexplained bruising and bleeding. Now you know why your surgeon will not allow you to take this prior to any procedures.

The treatment for any accidental ingestion of the ibuprofen is directly related to stopping damage related to the inhibition of the COX pathway.  If your pet has not already begun vomiting and they recently ingested a ibuprofen tablet, your veterinarian will attempt to get as much of the medicine out of their system as possible. They do this by inducing vomiting and giving activated charcoal to stop the absorption of the medication. If vomiting has begun, they will be given anti-emetic drugs to stop this. Intravenous fluids are very important. The fluids will help to flush the drugs from the animal’s system, and most importantly, it will help to keep the kidneys healthy. Also in the treatment cocktail, will be gastric protectants. These will be very helpful to protect the stomach and upper intestinal tract’s lining, and it will also allow any ulcers to heal. Unfortunately, if an ulcer perforates, surgery is the only option to repair that damage.  Seizure medication will also be administered if we have progressed to that point.

Naproxen has also become a very popular over the counter pain medication. I am not going to explain this medication in detail, because it will be basically a repeat of the ibuprofen explanation. It also acts by inhibiting the COX pathway. This medication is dangerous to our pets for the same reasons I explained above.

Prevention is very straight forward. DO NOT give any medication to your pets until you talk to your veterinarian. Pick up any medication that is dropped, and keep any and all medications in a cabinet or closet. Our pets can be very curious and we do not want them to accidentally chew up a vial containing medication that can harm them. We talk about child proofing our house. We also need to pet proof our house.

What is good for the goose, is not always good for the gander. Medications act differently in humans and in our pets. We cannot always share medication with our beloved pets. You must always listen to your veterinarian and follow their advice concerning any medication for your pets. Please keep any medication, especially over the counter pain medication, out of the reach of your little ones, human and pet.