What is acetaminophen?
Acetaminophen (Tylenol®, paracetamol, APAP, N-acetylparaminophenol) is a medication used for pain relief and fever reduction in people. It is a popular over-the-counter oral medication and is also available by prescription.
Acetaminophen may be the only ingredient in a medication or be part of a combination product containing other medications. These medications may include aspirin, opioids, antihistamines, decongestants, and caffeine. Typical uses in people include the treatment of fever, pain, colds, flu, and menstrual discomfort.
Acetaminophen is available in many forms, including tablets, capsules, gel caps, melt away tablets, rectal suppositories, and liquids.
Is acetaminophen toxic to pets?
Acetaminophen is often found in homes with pets. Poisoning may happen when pets get into the owner’s medications. In some cases, owners may administer acetaminophen to treat their pet’s pain. Low doses of acetaminophen may be recommended in dogs for certain indications but should only be given under the direction of a veterinarian. Acetaminophen should never be given to a cat, under any circumstances.
Why is acetaminophen poisonous to dogs and cats?
Acetaminophen is generally safe for humans at the recommended dose. However, pets metabolize acetaminophen very differently than humans, and even relatively small doses may be poisonous. Cats are especially sensitive to acetaminophen and, as a result, are more vulnerable to poisoning and develop symptoms at much lower doses than dogs.
What are the signs of acetaminophen poisoning in dogs and cats?
Dogs and cats may develop liver damage and changes to red blood cells, depending on the dose. Cats are more likely to develop red blood cell changes that interfere with the blood’s ability to provide oxygen to cells and tissues, followed by delayed liver damage. Dogs are more likely to develop liver damage at lower doses and red blood cell changes at higher doses. Small breed dogs may also be at risk for decreased tear production (dry eye).
Signs of acetaminophen poisoning can vary depending on the dose and species. Early signs in cats include:
- Stomach upset
- Decreased or no appetite
- Swelling of the face and paws
- Itchiness
Signs in cats progress to:
- Weakness
- Depression
- Pale or discolored (bluish) gums
- Breathing issues
- Panting
- Elevated heart rate (secondary to red blood cell changes)
- Liver failure
- Secondary kidney failure
- Death
Dogs can develop liver damage within several days of ingesting a small dose of acetaminophen. Symptoms include:
- Stomach upset
- Decreased or no appetite
- Depression
- Elevated heart rate
- Yellow discoloration of the skin, gums, and eyes (jaundice)
- Squinting, eye discharge, and eye pain (if dry eye occurs)
- Secondary kidney failure (rare)
Larger doses in dogs can cause symptoms within hours, including:
- Weakness
- Pale or discolored (bluish) gums
- Breathing issues
- Excessive panting
- Death
What should I do if my dog or cat eats acetaminophen?
If the exposure has just occurred and your pet is not yet showing any signs of illness, contact your veterinarian or Pet Poison Helpline, a 24/7 pet poison center for animals, at 800-213-6680. Early assessment and treatment increase the chance of a safe and successful outcome.
If your dog or cat is showing any signs of distress, immediately take your pet to your veterinarian or closest veterinary emergency clinic. Be sure to take the pill bottle and remaining pills with you. It is important to provide as much information as possible about the type of medication, amount ingested, timing of ingestion, and symptoms. It may be helpful to take an old blanket or towel in case your pet becomes nauseated and vomits during the car ride.
If vomiting occurs, check for any evidence of medication in the vomit, and note the amount present before discarding the vomit. If you cannot do this, save the vomit so the veterinary staff can examine it for you.
Try to stay calm and provide as much information as possible when requested by your veterinarian or Pet Poison Helpline. Provide information for all pets with access to the medication. This information is critical to determine the risk of poisoning and to provide the best possible recommendations for your dog or cat.
Information that may be requested includes:
- Age, weight, and breed of the pet
- Time of ingestion
- The amount of medication ingested (if the number of pills that was originally present in the bottle is known, count the remaining pills to determine how many were ingested)
- The strength of the medication (how many milligrams per pill or per milliliter)
- Any other ingredients present in the pills (e.g., antihistamine, caffeine)
- The pet’s medical history, including what other medication(s) they are taking
- Any current symptoms
How is acetaminophen poisoning treated in dogs and cats?
As with all poisoning cases, early intervention is key to successful treatment. Contact your veterinarian or Pet Poison Helpline, a 24/7 pet poison center for animals, at 800-213-6680 as soon as you realize your pet ingested acetaminophen. Your veterinarian may give your pet medical-grade activated charcoal to minimize absorption of acetaminophen from the gastrointestinal tract. Supportive therapy will be offered, including fluid support and appropriate medications to treat your pet’s clinical signs and to support organ function. Hospitalization may be needed. Treatment in cats may be more prolonged than in dogs due to a cat’s greater level of sensitivity to acetaminophen.
What is the prognosis for recovery?
The prognosis for dogs and cats is excellent if an exposure is treated early. Delays in treatment or lack of treatment greatly reduce the chances for a successful outcome, and permanent organ damage or death is possible.
How can I prevent acetaminophen poisoning in my pet?
- Never give any medication to a pet without first consulting a veterinarian.
- Do not leave any medications, including vitamins and supplements, where unattended pets may reach them.
- It is common for pets to chew through closed bottles.
- Curious pets may want to check out purses, backpacks, lunch boxes, or suitcases.
- Some pets will open lower cabinets or get into open drawers.
- Pets can get on counters or knock items off counters and tables.
- Do not assume a pet will avoid eating medication just because it has a bad taste.
- If you drop a medication on the floor, confine all pets in another area of the home until all the medication can be picked up.
Pet Poison Helpline, a pet poison control center based out of Minneapolis, MN, is available 24/7 for pet owners and veterinary professionals that require assistance treating a potentially poisoned pet. The staff provides treatment advice for poisoning cases of all species, including dogs, cats, birds, small mammals, large animals, and exotic species. As the most cost-effective option for animal poison control care, Pet Poison Helpline’s per-incident fee includes follow-up consultations for the duration of the poison case. Pet Poison Helpline is available in North America by calling 800-213-6680. Additional information can be found online at www.petpoisonhelpline.com.
