Cat Acetaminophen Toxicity

CAT FANCY and CatChannel have compiled common cat health concerns, their description and cats? medical treatment options.

By Arnold Plotnick, DVM |

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Cherry plum flowers
A Heinz Body blood smear depicting anemia
Disorder: Acetaminophen Toxicity

Description:
Acetaminophen is a non-steroidal anti-inflammatory drug used for pain and inflammation in humans and dogs. Mostly known by the trade name Tylenol, acetaminophen is the major ingredient of most aspirin-free pain relievers and cold remedies like Excedrin, Panadol, Anacin, Midol, Pamprin, BromoSeltzer and Percogesic. Many decongestant products and “cold” or “flu” formulas (for example, Nyquil) also contain acetaminophen.  Although safe doses have been reported for dogs, no safe dose exists for cats. In cats, the drug is highly toxic.

Signs:
•    Chocolate-brown mucous membranes
•    Tachycardia (fast heart rate)
•    Dyspnea (labored breathing)
•    Vomiting
•    Edema (swelling) of the face, neck and limbs
•    Hypothermia (low body temperature)
•    Ataxia (uncoordinated walking)
•    Coma
•    Jaundice (if liver failure develops)

Causes:
Cat acetaminophen ingestion, either accidental (cat manages to break into a bottle or vial of the drug, or ingests the drug off the floor or counter), or deliberate (owner administers the drug deliberately for pain or illness, unaware of the toxic nature of the drug; this latter scenario is more common.)

Diagnosis:
Diagnosis is usually based on a history of having ingested the drug, appropriate clinical signs, Heinz Body anemia (an anemia type diagnosed by examining a blood smear, usually done by the clinical pathologist at the diagnostic laboratory) and elevated liver enzymes.

Immediate Care:
Acetaminophen ingestion is a true veterinary emergency, and the timing of the treatment has a direct effect on survival. The sooner a cat is treated, the better chance of survival. If acetaminophen toxicity is suspected, a vet must examine the cat immediately. Bring the package or prescription vial of the suspected drug with you to your cat's veterinarian.

Long-term Care:
Signs of recovery within 48 hours of beginning treatment indicate a positive response to treatment, and some cats make a full recovery. Treatment begun beyond 8 hours after ingestion is rarely successful.    

Never give other over-the-counter non-steroidal anti-inflammatory drugs such as ibuprofen (Advil, Nuprin, Motrin) or naproxen (Aleve) to cats. Ibuprofen has a narrow margin of safety in dogs, and experts believe cats, with their inability to metabolize these drugs, are twice as sensitive as dogs to ibuprofen’s toxic effects.  

Possible Medications/Treatments:
•    Induce vomiting (if ingestion was recent)
•    Activated charcoal (if ingestion was recent)
•    Oxygen
•    Intravenous fluids
•    N-acetylcysteine
•    Vitamin C
•    Cimetidine (Tagamet)

Prognosis:
Guarded. If treated immediately, cats may do well. If treatment is delayed beyond 8 hours after initial ingestion of the drug, the prognosis is poor.  

Possible Side Effects:
No significant side effects for any of the recommended treatments
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