Medication Mix-Ups

March 13, 2014
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Photo: aspca.org

Next week is Poison Prevention Week. According to ASPCA Animal Poison Control, the number one cause of poisoning in pets is prescription and over the counter drugs. The poisoning occurs because pets inadvertently consume either pet or human medications. To help raise awareness of potential sources of pet poisoning, here are some recent issues with medications reported to the veterinarians at The Animal Medical Center.

Name Swap
Most drugs have a brand name like Lasix® or Amoxi-tabs® and a corresponding generic name like furosemide or amoxicillin. I will admit I may use the brand name when speaking with pet owners but write a prescription for the generic medication because the generic brand is typically less expensive, though equally as effective. This dual naming system often creates confusion for the pet owner sometimes resulting in double medicating the pet. Oreo has heart failure and is being treated with Lasix. A second prescription of the same medication from a specialist said furosemide. The owner administered the new medication along with the old medication because she didn’t know the two were the same drug. Fortunately, the error was recognized and no harm came to Oreo.

Rainbow Roulette
Please keep in mind that your veterinarian usually doesn’t see the pills dispensed to your pet. Because I don’t see the pills, your description of “the oblong blue one” doesn’t help me determine the medication prescribed. Also keep in mind that generic medicines can be the same drug, but manufactured in different colors. If a medicine is dispensed and does not look like the last prescription for the same medicine, don’t hesitate to ask the pharmacist or someone at your veterinarian’s office to be sure the correct medication was dispensed.

A Pill for You and a Pill for Me
Last week one of our cat patients was inadvertently given one of her owner’s medications. Both pill bottles were sitting side by side on the counter. Even worse, the medication contained Tylenol® (acetaminophen), a human drug which is very toxic to cats. The owner quickly recognized the problem and successfully induced vomiting, but it could have been a disaster for the cat.

Yes, We Mean Three Times a Day
Three times a day does not mean, put all three pills in the food and hope your pet eats a bite of food containing a pill every eight hours. Don’t count on your pet to count the hours between doses. Give each pill separately at the prescribed intervals to avoid over- or under-dosing your pet.

Words to the Wise

  • Ask the prescribing veterinarian what each medication prescribed for your pet is meant to treat. If there are multiple medications to treat the same problem, ask if they are duplicate medications with different names on the labels.
  • If you see more than one veterinarian for your pets multiple problems, take all the medication bottles with you to each visit. Be sure each veterinarian knows what the other has prescribed.
  • Do not talk about the color of the pills with your veterinarian. We prefer the names of the medication to be read off the bottle. Even badly pronounced drug names are better than a description like “the white one, a little smaller than a dime.”
  • To avoid a medication mix-ups, store your medications in a different location than you store Fluffy’s.
  • Keep the toll free number of an animal poison hotline handy for an emergency:

- Pet Poison Helpline (800) 213-6680
- ASPCA Animal Poison Control (888) 426-4435


Preventing Foodborne Infections in Pets

June 13, 2011

Foodborne illness has been in the news all week. First, the massive multi-country European outbreak of E. coli has sickened over 1,000 people and killed more than 20.

Closer to home, the United States Food and Drug Administration notified consumers of multiple recalls due to possible salmonella contamination in pig ear treats and a raw diet for cats. This type of news has veterinarians, including us at The Animal Medical Center on alert for illness possibly related to food.

Food and water can become contaminated with salmonella and E. coli bacteria if they come in contact with fecal material or if the processing plant is contaminated. Cooking readily destroys both of these bacteria. Neither of the recalled pet products was cooked. One was a diet designed to be fed raw, and pig ears are frozen and dried, but not cooked.

Both salmonella and E. coli are enteric bacteria and are commonly spread when contaminated food and water are ingested. Ingestion of salmonella or E. coli contaminated food or water can result in gastroenteritis, fever and abdominal pain in both humans and pets.

How can pet owners protect their pets and themselves? The June 1 issue of the Journal of the American Veterinary Medical Association offers suggestions on safe feeding practices. I have summarized them here.

  • Avoid feeding raw food diets.
  • Avoid purchasing bulk pig ears, buy individual packets.
  • Return pet food to store if it is discolored or has a bad smell.
  • Store pet food according to the manufacturer’s recommendations.
  • Save packaging and product codes for pet food to facilitate identification of a recalled food.
  • Children, the elderly and immunosuppressed humans should not handle pet food and treats.
  • Wash hands with soap and water before and after handling pet food and treats.
  • Wash pet water and food bowls regularly.
  • Keep human and pet foods separate.
  • Discourage humans from eating pet foods and treats.

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This may also be found in the “Tales from the Pet Clinic” blog on WebMD.com.

For over a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.


10 Reasons to Go to the Pet ER Now!

May 16, 2011

Although I regularly share pet healthcare information on the AMC blog, I also like to remind readers that this information is not a substitute for a vet visit. You should always contact your veterinarian in an emergency. In case you are unsure as to what constitutes a pet emergency, here are my top ten reasons to take your pet to the ER (in no particular order):

1. Vomiting or diarrhea — not the run of the mill variety, but more than 2 or 3 times in an hour or if it is bloody. If the retching is unproductive in a dog with a distended abdomen, worry about bloat.

2. Red eye, runny eye or an eye injury. The littlest eye injury can quickly turn into a big problem.

3. Ingestion of a possible toxin, such as antifreeze (ethelene glycol), rat poison, human medications or a toxic plant.

4. Difficulty breathing or excessive coughing. Your dog might hold her head and neck extended to get more air or your cat might start breathing through his mouth.

5. Traumatic event such as being hit by a car or falling from a window. On the outside your pet might look fine, but internally may have suffered a serious injury.

6. Straining to urinate, especially if no urine is being produced.

7. Collapse, loss of consciousness or a possible seizure. Early intervention could prevent another one of these frightening episodes.

8. Bleeding from anywhere: a cut, a torn toenail or serious bruising under the skin.

9. An acute allergic reaction, especially if it involves swelling of the face and could compromise breathing.

10. Just to show the ER doctors how much better your pet is feeling and to thank them!

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This may also be found in the “Tales from the Pet Clinic” blog on WebMD.com.

For over a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.


Lilies and Your Cat

April 21, 2011

The genesis of this week’s blog did not come from one my patients at The Animal Medical Center, but from a trip to my local Food Emporium. As I walked in through the produce section, the smell of lilies wafted towards me. They were beautiful…and deadly, at least to cats.

The entire lily family, including Easter lilies, Asian lilies, the elegant calla lily and even the feline named tiger lily should be off limits for cat owning households. The toxic substance in lilies is unknown but the toxin appears to affect only the cat and not the dog. In addition to finding a freshly mangled plant on the windowsill, cat owners will see vomiting and diarrhea following lily ingestion. Blood tests often reveal kidney failure which in some cases can require treatment with dialysis and may be fatal.

Photo: Ann Hohenhaus, DVM

Lily ingestion is a year round problem because some cats cannot resist sampling the vegetation used to decorate the house — and the problem is not just with lilies. Many other ornamental plants can be toxic to cats. Common springtime flowers on this list include amaryllis, crocus, narcissus, daffodil and azalea. Cat owners must carefully select their houseplants to avoid a trip to the emergency room following unplanned consumption of a toxic cat salad.

If your cat inadvertently ingests one of these plants or any other plant for that matter, contact your veterinarian’s office to determine if treatment is necessary. You may also contact one of the animal poison control services included in the links below. These services are open 24 hours a day to advise pet owners and veterinarians on optimal management for pet poisonings.

Animal Poison Control Center

Angell Poison Control Hotline

Pet Poison Helpline

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This may also be found in the “Tales from the Pet Clinic” blog on WebMD.com.

For over a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.


Halloween Hazards

October 19, 2010

For children, Halloween is a long anticipated holiday featuring parties, costumes and above all, candy. Adults celebrate the holiday too, by decorating their homes and yards with ghosts, goblins and jack o’lanterns. But as you can see by the photo above of my cat, Cheetah costumed as Minnie Mouse, pets don’t enjoy Halloween.

Trick or treaters constantly ringing the doorbell can make an anxious pet even more so. When the treats are passed out at the front door, they may try to escape the commotion, slipping outside unnoticed. I recommend confining your cat or dog in its crate or one room of the house while you receive trick or treaters to prevent your pet from being one of the estimated 3-4 million pets entering shelters annually. Only 25% of these pets are reunited with their families. If confining your pet is not possible, double check their collar and ID tags and if they don’t have a microchip get one to help your pet come home if it succeeds in escaping while you dole out the treats.

Halloween food presents another risk for your pets, particularly dogs. Dogs can have quite a sweet tooth and will devour the entire contents of a goodie bag, but cats are too finicky to be tempted by sweets. Just like with children who over indulge on Halloween, too many treats will cause an upset stomach, or worse, vomiting and diarrhea. So keep the cauldron of treats out of reach of your dog.

Feasting on two specific sweets may end in a scary visit to the veterinary emergency room – chocolate, especially dark chocolate and xylitol. Chocolate contains a substance related to caffeine and the darker the chocolate, the more caffeine like substance it contains. Small dogs that eat chocolate are especially at risk for developing vomiting, diarrhea, an elevated heart rate and hyperexcitability. Xylitol is a low calorie sweetener in some diet foods, gum and mints. It is safe for humans, but lethal for dogs who develop low blood sugar, seizures and liver problems. If your pet eats something other than their usual fare on Halloween, don’t hesitate to call Animal Poison Control (888) 426-4435 to find out if you should head to the Animal ER. They take calls 24/7.

When pets are around, jack o’lanterns can be risky. Pumpkin is appealing to some dogs and cats, but that is not the problem. It is the candle inside. Pet hair can easily cat on fire if a nosy or hungry pet decides to investigate the jack o’lantern. Better to use a battery operated flickering light, which will be safer for everyone.

And if you want to see some really cute pets ready for trick or treating, check out WebMD or The AMC Facebook page.

This blog may also be found in the “Tales from the Pet Clinic” blog from WebMD.
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For nearly a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.


Medication Toxicity

August 3, 2010

Late last week, the United States Food and Drug Administration issued a warning to women who use the drug Evamist®, made by Ther-Rx Corporation to treat the symptoms of menopause. Exposure to this medication can have negative affects on both children and pets.

Evamist is sprayed on a woman’s arms to reduce hot flashes. Two cases of toxicity have resulted in female dogs and ingestion of the spray was the result of licking or being held in their owner’s arms. Signs of toxicity are not immediate. If contact between the sprayed skin and a pet cannot be avoided, women should cover their skin with clothing.

The Evamist problem is just the tip of the iceberg when it comes to medication toxicity and pets. VPI (Veterinary Pet Insurance) reports nearly 20,000 claims for poisoning of pets during the 4 years between 2005 and 2009. The number one cause of pet poisoning, you guessed it, is accidental exposure to human or pet medications. The average policyholder claim was $791 dollars per poisoning episode.

Medications poisoning can occur a variety of ways. Pet owners may simply want their sick or painful pet to feel better and administer their own medications. This commonly occurs with owner-administered non-steroidal, anti-inflammatory drugs such as ibuprofen and naproxen. Acetaminophen is another potentially deadly pain reliever. Cats are very sensitive to its effects and can develop anemia, but dogs develop liver problems. Pills are easily dropped unnoticed, but if your pet jumps on every dropped object like it is a tasty morsel, down goes the pill. I’ve seen pets ingest their owner’s antidepressant medications this way and end up in the AMC ICU.

Because pets are superbly clever, they always find new ways to cause trouble. Some inquisitive dog got into trouble by prowling in the bathroom trash. He found a cotton swab used to apply a skin cancer drug. According to Animal Poison Control, the residual drug on the cotton swab was enough to cause severe toxicity, even death. Cats are also sensitive to this drug.

Animal Poison Control is a 24 hour a day, seven day a week service, available to pet owners and veterinarians. The $65 fee provides medical advice to veterinarians and peace of mind to the pet owner. Once the fee has been paid for an episode of poisoning, additional calls related to the poisoning incident can be made without additional charges. The Animal Poison Control number is (888) 426-4435.

The Animal Medical Center is open 24 hours a day, 7 days a week for emergency, routine and specialty care: (212) 838-8100.

The Animal Medical Center
For 100 years, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.


Making a Pet First Aid Kit

January 7, 2009

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Every pet owner should put together a pet first aid kit – a handy, easily created resource that will help a pet owner think and act quickly in the event of an emergency. 

Pack the listed items in a clear container to facilitate finding them quickly.  Include an emergency telephone list inside the kit, or you might even tape it to the outside of the container.  Having these numbers on hand will allow the first response to an emergency to be a telephone call to the appropriate emergency information source.  The telephone list should contain:

• Your veterinarian’s telephone number and address
• The telephone number and address of the closest veterinary emergency facility
• The number of your local animal ambulance or transportation service
• Animal Poison Control: 1-888-426-4435*

*The advice is well worth the Animal Poison Control user’s fee.  If you call, be sure to record your case number and give it to your veterinarian who can contact them for additional consultations about your pet.

First aid kit items:

  1. Muzzle: Should be of the appropriate size for you pet.  Injured pets are likely to bite even their owners due to pain or fear.  Muzzling protects the person caring for them in an emergency.
  2. Tweezers: For splinter or tick removal
  3. Nail trimmer: Ask your veterinarian for the style of trimmer right for your pet.   For cats, my personal favorite is the $1.29 one available at the checkout counter of your local drug store.
  4. Blunt-tipped scissors: Handy for hair clumps and trimming out foreign material like burdocks and plants.
  5. Pre-packaged povidone-iodine cleaning pads: Use to clean off first-aid-kit1cuts and wounds.  Follow cleaning with a clean water rinse to remove the soap.
  6. Saline solution: Regular human contact lens saline solution can be used to flush out dirt, sand or other irritants – just squeeze the contents directly into the eye.  The nozzle tip of these bottles makes it very useful to direct the saline into a cut or scrape to flush out sand and dirt.
  7. Triple antibiotic ointment: To place directly on a cut after it has been cleaned with povidone-iodine and water.
  8. Sterile petroleum jelly: Put ¼ inch in each eye to protect it from soap or povidone-iodine if cleaning a wound around your pet’s eyes.  Works well if you’re bathing your pet, to prevent soap and water from getting in the eyes.
  9. Sterile nonstick pads: Sticky bandages and fur don’t mix. Wrap the wound with the pads before placing a bandage on your pet.
  10. Bandage material: Elastic bandages or gauze, which can be used to hold a nonstick pad in place.
  11. Peroxide: To only be used to induce vomiting when Animal Poison Control instructs you to do so.  You should call Animal Poison Control when your dog or cat has consumed something from the pet toxins list.  Peroxide should NOT to be used for cleaning wounds, as it slows healing.
  12. Leash: In case the accident happens when you don’t have one available. Use only if the pet is able to walk.
  13. Towel: A big, clean cotton towel to dry the pet off, to keep him/her warm, to cover a cut or to use when applying pressure to stop bleeding.

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