When You SHOULD Induce Vomiting

pill-316747_1280We recently discussed when NOT to induce vomiting after your pet has eaten certain harmful items. Today we’ll look at common situations where you should induce vomiting (how-to instructions below).

  1. Rodent poisons often contain anti-coagulant (blood-thinning) drugs such as coumarin or warfarin; newer products contain bromethalin, a neurotoxin that is equally dangerous. If a pet ingests an anti-coagulant, or even eats an animal that has consumed it, life-threatening internal bleeding may occur. While symptoms typically take 5 to 7 days to develop, they need to be headed off by inducing vomiting within six hours, if you know that such products were consumed. Follow up with an oral dose of activated charcoal. Further treatment with Vitamin K will still be needed for several weeks.
  2. Chocolate is a well-known toxin for pets (but not for us, thank goodness!). Theobromine and caffeine are the primary offenders. The risk is highest in baker’s, semisweet, and dark chocolate; cocoa powder; and cocoa beans. These are all concentrated sources of these compounds. Chocolate-flavored products, like chocolate cake or ice cream, are unlikely to cause harm; but to be safe, do check with your vet. Inducing vomiting within about 6 hours can prevent ill effects. Follow-up treatment with activated charcoal will need to be given every 4-6 hours for the next 24-48 hours, because the liver recycles and recirculates theobromine.
  3. Human pain relievers, including acetominophen (Tylenol), ibuprofen (Advil, Motrin), and naproxen (Aleve) are all toxin to cats and dogs. Gel caps are the most dangerous because the gel melts quickly and the drug acts fast. In any case, induce vomiting as soon as possible if a pet ingests any of these drugs. Activated charcoal should also be given every 4-6 hours for 48 hours.
  4. Xylitol is an artificial sweetener that’s used in many sugar-free products, including gum, bakery products, candy; vitamins; and even toothpaste. It is highly toxic to dogs, who tend to enjoy sweets; cats are less likely to get into these products since they have no taste buds for sweet. Xylitol triggers insulin secretion, which can quickly lead to severe hypoglycemia (low blood sugar) with weakness, lethargy, and seizures. Symptoms can occur from 30 minutes to 12 hours after ingestion, and can be fatal if not treated promptly. Large doses, such as in baked goods, can also cause liver failure, which has a poor prognosis. It’s essential to induce vomiting immediately. In this case, however, activated charcoal is useless because the xylitol molecule is too small for it to bind.
  5. Antifreeze (ethylene glycol) is extremely toxic in very small amounts. If a cat walks through a puddle of antifreeze, as little as ¼ teaspoon sticking to the paws is enough to cause acute kidney failure when the cat licks it off. Inducing vomiting is effective if done within 2 hours of ingestion.

How to Induce Vomiting

First and foremost, never undertake this treatment unless directed by your veterinarian or a poison control agency! This means you are on the phone with an expert while you’re working on it.

If your pet is already vomiting; is unconscious or too weak to stand and walk; or has already developed symptoms of poisoning; or if it’s outside the effective time window; then it’s too late; do not proceed.

Do not induce vomiting in an animal with a history of seizures, recent surgery, bloat, laryngeal paralysis, tracheal collapse, megaesophagus, or heart disease.

Never induce vomiting in brachycephalic (short-nosed, smush-faced) breeds like Persian or Himalayan cats, or dog breeds like Pug, Pekingese, Bulldog, Lhasa Apso, and Shih Tzu, due to the risk of aspiration (inhalation). It is still somewhat risky in less extreme breeds, like British Shorthair cats, Boxers, Cavalier King Charles Spaniels, Shar Peis, and Newfoundlands.

Hydrogen peroxide 3% is the most common agent; give 1 teaspoon (5 ml) per 10 pounds of the pet’s body weight. It’s not foolproof, but if it’s going to work, vomiting should commence in about 15 minutes. It’s said to be helpful to feed a small amount of wet food before giving the peroxide, to help gather up and mobilize whatever else is in the stomach. Peroxide will remove 40-60% of stomach contents in one shot; a second dose 15 minutes after the first may be needed.

Syrup of Ipecac has fallen out of favor because it has serious side effects and is quite harmful if inhaled, but in a pinch, your veterinarian may recommend it. It is more reliable than peroxide. It should not be used in animals with heart or gastrointestinal disease. Follow your veterinarian’s instructions precisely.

Activated charcoal is often recommended as a follow-up treatment. It adsorbs (soaks up) most toxins and escorts them out the other end. It is usually given as a liquid. It is, of course, coal black. It can be bought in liquid form or as a powder to mix with water. It is thick and very, very messy. (Unfortunately, it is not effective in capsule form.) Activated charcoal will turn stools black, and may cause either diarrhea or constipation.

After vomiting is over, flush the mouth and esophagus thoroughly with water or weak, cooled black tea. Peroxide can cause chemical burns to those tender tissues if not removed, especially in cats.

If you know or suspect that your pet has eaten something questionable, call your veterinarian, ASPCA Animal Poison Control, and/or Pet Poison Helpline immediately! Emergency treatment and/or further care may be necessary.

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