How About a Charcoal Milkshake?

Mmmmmm. We have a glamorous job sometimes. What with the poop and pee and all sorts of other excretions from hospitalized and nervous critters, I thank God I have such a dedicated nursing and hospital attendant staff willing to step in and clean, change bedding and litter boxes and hose out runs if there is even a whiff of a need. I have a very sensitive sense of smell, and know how important it is to clients that a hospital is clean without smelling like super strong disinfectants. We are lucky to be located adjacent to a Subway Sandwich store....the dogs often come in drooling and licking their lips wondering where their tasty morsels are!

This morning we had another "fun" excretion experience thanks to a new patient, Cinnamon. It seems Cinnamon ate 10 - 15 of her owners prescription strength 800mg Ibuprofen tablets. Now, we don't use this medication in dogs or cats at all since there are so many safer ones available, but if we had to come up with one, a suggested dose would be around 180mg TOTAL for a dog of Cinnamon's size. Certainly not 8000 to 12,000mg! The immediate concerns for ibuprofen overdose is for gastric ulceration. Her owners were pretty sure she ate those pills within 45 minutes of her arrival at the veterinary hospital. Good for them for getting her in so quickly.
We always call poison control when we have a suspected toxicity case coming in. They can be very helpful, give us a case number and follow up with us later. I think they like breaking up the monotony of working on "boring old humans" all day by getting an interesting animal case in once in awhile. (I also have a link to the ASPCA's Poison Control service on my website. They are available 24 hours a day and all pet owners should know about their wonderful service.)
OK, now for the "fun" excretion experience. We administered Cinnamon a drug called apomorphine intravenously to induce emesis (vomiting) and then stood back and let her rip. I feel so bad having to do that to critters, but in a supervised setting with the proper medications, it is an important part of the treatment plan for some toxicities. It used to be very common to tell owners to give hydrogen peroxide automatically if their pet had eaten something bad. We are finding more and more problems with pets who get peroxide, including stomach bleeding, so we really do recommend getting your pet to a vet if at all possible. Somethings that are ingested should NOT be vomited back up due to dangers of aspiration (inhaling the material into the lungs) which can be worse than the original toxicity or can be caustic to the esophagus. Always check with your veterinarian or poison control before inducing emesis in your pet.

Cinnamon vomited (sorry about the graphic descriptions here!) chunks of food, lots of brown fluid and some green plastic looking things, but no obvious white tablet material that the owner said the pills looked like. So the lucky girl got to experience the next fun step in treating over-doses...activated charcoal. We made a slurry out of the powdered charcoal we keep for this purpose and placed a tube into Cinnamon's stomach (made easier because she was a bit quiet from the sedation effects of the apomorphine.) We were only able to give her half of her calculated dose before she acted a bit uncomfortable, so pulled the tube and will give her the rest in about an hour. The charcoal will hopefully absorb any toxins (the ibuprofen) remaining in her system.

We placed an IV in Cinnamon so we could diurese her (flush fluids through her system) in hopes of warding off the secondary effects of ibuprofen overdose, damage to the kidneys and possibly other organs. She's getting medications to protect her stomach lining and antacids and we are watching her very carefully. We'll check her blood values later to see if she has any long term damage or if she lucked out by having owners who got her in right away for treatment. Cinnamon has only been with these humans for 2 weeks-they just adopted her from the shelter! They didn't know her very well yet, but I guess now they know one thing about her, she likes to get into things she shouldn't. Time to "Cinnamon-proof" the house!

Peace,
DrReneigh