Dr. Justine Lee discusses feline asthma and asthma inhaler poisoning in dogs. For more from Dr. Lee, find her on Facebook!
Asthma, which can be seen in humans, horses, and cats, can be life threatening without treatment. In cats, clinical signs of asthma include:
- coughing (which sounds like “hacking up a hairball” in cats)
- shortness of breath
- open-mouth breathing
- exercise intolerance
- difficulty breathing
- blue gums
- acute death
In veterinary medicine, an acute asthmatic attack requires a visit to the emergency veterinarian for oxygen therapy and medications to alleviate the bronchoconstriction (e.g., constriction of the airways). Specific medications include corticosteroids (e.g., prednisolone) and lung expanders (e.g., bronchodilators such as theophylline, albuterol, etc.).
Long-term management of asthma includes the use of human asthma inhalers with a pet-specific chamber (so the drug can be delivered through a mask) called an AeroKat or AeroDawg chamber. Long-term management also includes environmental changes such as eliminating allergens (e.g., like smoke, dust, kitty litter dust, etc.) and using high-efficiency particulate air (HEPA) filters.
Most of the time, asthma can be well controlled when these changes are implemented (learn more about feline asthma).
However, before you bring home that asthma inhaler, pay heed.
Typically, your veterinarian needs to write a prescription for an asthma inhaler (which you can fill at a human pharmacy). While the medication can be expensive (ranging from $70-110/canister), it can be life-saving and very easy to administer. However, asthma inhalers are the perfect chew toy in your dog’s eyes.
Asthma inhalers contain certain drugs (e.g., albuterol, fluticasone, etc.), are made of plastic and pliable aluminum (that’s easy to chew into), and often contain a weird, intriguing smell. If your dog accidentally chews into an inhaler containing albuterol, it can be extremely poisonous to your dog. Either a human or cat inhaler can be dangerous. Thankfully, cats typically won’t chew into asthma inhalers (due to their smaller mouth and more discriminating habits). However, when dogs chew into an asthma inhaler, one puncture can result in all of the pressurized drug being inhaled within seconds (Some of these asthma inhaler canisters containing 200 doses of drug). This causes concentrated albuterol to rapidly be absorbed from the mouth, resulting in toxic symptoms within seconds to minutes.
With an overdose, albuterol inhalers can have a stimulant effect on the heart (and lungs). When ingested by a dog, it can result in dangerous clinical signs including:
- a racing heart rate
- red gums
- panting excessively
- severe electrolyte changes (a low potassium)
- acute death
An immediate trip to the veterinarian or emergency veterinarian is imperative. Treatment includes aggressive IV fluids, blood work (to monitor the potassium levels), drugs to slow the heart rate down, sedation, and heart and blood pressure monitoring. With supportive care, treatment is fair to good; however, treatment can be expensive as 24/7 care is typically required.
When in doubt, prevention is key! Keep your inhalers in convenient areas, but behind cupboard doors or within a closed drawer. While these medications can be life saving for asthma, they can be dangerous with an overdose situation.
If you have any questions or concerns, you should always visit or call your veterinarian – they are your best resource to ensure the health and well-being of your pets.
Monday, December 15, 2014
Asthma inhalers in dogs
Many people in the UK suffer from asthma and inhalers are commonly prescribed to help manage the symptoms. Inhalers vary but will mostly contain either a steroid or a drug that helps open the airways although there are a variety available and some contain both.
The steroid inhalers which are taken regularly to help prevent attacks occurring are usually brown in colour. The inhalers intended to help reduce the symptoms of an attack usually contain a drug called salbutamol and are coloured blue. One of the most common brand names is Ventolin.
Dogs may find the tough containers fun to chew on and can sometimes puncture them. Because they are pressurised containers, when punctured the drug will rush out and the inhaler may even shoot across the room! Because of this explosive release the dose of drug squirted out and eaten or inhaled can often be large – the whole inhaler’s worth.
What will happen if my dog bites an asthma inhaler?
There are various signs you could see.
1) Puncturing the pressurised container can cause burns:
One problem with these inhalers is that the release of gas from the puncturing of a pressurised container can sometimes lead to a ‘frost-bite’ burn in the mouth that may be painful for the dog. So watch out over the next 24 hours for signs such as soreness/redness in the mouth or face, not wanting to eat, drooling, being unsettled or having difficulty breathing.
2) Puncturing salbutamol inhalers (coloured blue) can cause poisoning:
The first signs you are likely to notice are vomiting, lethargy, panting. Also, your dog’s heart will start to race although this is not easily seen by the owner. These effects can be severe requiring close monitoring, and dogs will also need blood tests to check for changes to their potassium levels. They may be very restless or agitated, wobbly on their feet, thirsty or weak. Shaking or twitching can happen too, as well as an increased body temperature and irregular heartbeat. In serious cases or where effects have been prolonged long term heart damage can occur.
What should I do if my dog has punctured an asthma inhaler?
If the inhaler only contains a steroid, the risk of poisoning is low, but you need to watch out for the development of a burn in the mouth over the next 24 hours.
If the inhaler contains salbutamol or a similar drug, treatment at the vets may be required.
If in doubt, call Animal PoisonLine and we can advise you whether you need to make a trip to the vet or not.
The Inhaler is Not a Chew Toy
If your pup doesn’t have breathing challenges but you do, it’s vital to take care that he doesn’t get into your albuterol. Though it seems unlikely your dog would end up snacking on your inhaler, consider that many dogs love to chew and an inhaler may be just the right fit for his mouth. In fact, Pet Poison Helpline lists asthma inhalers as one of the top five hazardous handbag items. If your dog chews on your inhaler, he can suffer from canine albuterol toxicity. Inhalers contain concentrated doses of medication, allowing your pup to ingest massive amounts of albuterol at once, with potentially lethal consequences.
Which top human medications are poisonous to pets?
It was recently revealed that the prescription drugs Americans spend the most money on are (in this order): Lipitor, Nexium, Plavix, Advair Diskus and Abilify.
And this week, Pet Poison Helpline released a look at how those medications affect cats and dogs — because pets have a tendency to get into their humans’ meds.
“Nearly half of the calls we receive are for pets that have accidentally ingested human medications,” Pet Poison Helpline’s Justine Lee, DVM, says in the press release.
Here’s a summary of the report (see a PDF of the full press release here). Note: Even if a substance is considered not highly toxic, call your vet
immediately if you think your pet has ingested it. Better safe than sorry.
5. Abilify: Abilify, used to treat depression, schizophrenia and bipolar disorder, can cause severe lethargy, vomiting, hyperthermia (overheating) and seizures in your pet, and have a major impact on her heart rate and blood pressure — if she ingests this drug, take her to the vet ASAP.
4. Advair Diskus: If your dog chews into one of these asthma inhalers, he’ll be exposed to high doses of medication and can experience heart arrhythmia, an elevated heart rate, agitation, vomiting and even acute collapse. Another side effect is severe electrolyte abnormalities, which can be deadly. If you think your pet has gotten into this medication, take him to the vet immediately.
3. Plavix: In humans, Plavix inhibits blood clotting and reduces the risk of stroke. It’s generally not considered acutely toxic to dogs and cats, and will probably cause only mild vomiting or diarrhea.
2. Nexium: An anti-ulcer medication, Nexium is sometimes given to pets by veterinarians, with mild side effects such as vomiting and diarrhea. If your dog or cat gets into your Nexium, keep a close eye on her, but her symptoms will most likely go away on their own.
1. Lipitor: This cholesterol drug is not considered highly toxic for pets — your dog or cat will probably have only some vomiting or diarrhea if he ingests it.
I asked Dr. Lee if Pet Poison Helpline’s advice on the five medications applies to pets other than cats and dogs, such as rabbits, guinea pigs, ferrets and birds.
“For the most part, if it’s harmful to a dog or cat, it’s likely more
dangerous to other pets,” she says. “They have a faster metabolism and
unique anatomy, making it potentially deadly for them most of the time.”
No matter what kind of pet you have, if you think she has eaten
something poisonous, call your vet or one of the pet-poison hotlines
listed below (charges may apply).
“The sooner you identify the poisoning and get it treated,” says Dr.
Lee, “the less
harmful to your pet, the easier to treat, and the less expensive [it may
Pet Poison Helpline – $35 a call
ASPCA’s Animal Poison Control Center – $65 a call, or free unlimited calls with a $16.99-a-year HomeAgain membership.
Tell us: Have you ever had a pet-poisoning scare? What happened?